Case Series for Transradial Approach in Fistulograms for Arteriovenous Access

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Nephrology

Background:

• Traditional arteriovenous (AV) access interventions involve direct fistula or graft puncture.
• The transradial approach (TRA) allows for single-point arterial and venous access for visualization and intervention.
• Assessing TRA for fistulograms is crucial for improving AV access management.

Purpose of the Study:

• To evaluate the clinical success of TRA fistulograms.
• To assess functional patency, flow rates, and complication rates associated with TRA.
• To compare TRA as an alternative to traditional access methods for AV fistulograms.

Main Methods:

• Retrospective analysis of 255 patients undergoing TRA fistulograms (2017-2023).
• Analysis of patient demographics, lesion types, and 3-month postoperative complications.
• Flow rate measurements pre-intervention and at 1, 3, and 6 months post-intervention; paired t-tests used for comparison.

Main Results:

• Mean preoperative flow rate of 456.5 cc/s increased significantly at 1, 3, and 6 months post-TRA (751, 878, 741 cc/s, respectively; P < 0.05).
• Technical success rate was 94.9%.
• Complications included ruptures (1.6%), access site issues (3.9%), and AV fistula thrombosis (6.7%).

Conclusions:

• TRA for fistulograms demonstrates significant improvement in functional patency for malfunctioning AV access.
• This approach offers a convenient, single-puncture alternative to traditional methods.
• TRA is particularly effective for venous outflow and juxta-anastomotic lesions with minimal complications.