Transpedal vs. femoral access for peripheral arterial interventions-A single center experience.
Aged
Aged, 80 and over
Catheterization, Peripheral
/ adverse effects
Cross-Sectional Studies
Endovascular Procedures
/ adverse effects
Female
Femoral Artery
/ diagnostic imaging
Foot
/ blood supply
Humans
Male
New York City
Peripheral Arterial Disease
/ diagnostic imaging
Punctures
Radiation Dosage
Radiation Exposure
Radiography, Interventional
/ adverse effects
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
COMV-complications
ENDI-endovascular intervention
PAD-peripheral arterial disease
vascular access
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 Jun 2019
01 Jun 2019
Historique:
received:
24
06
2018
revised:
29
01
2019
accepted:
16
03
2019
pubmed:
29
3
2019
medline:
7
7
2020
entrez:
29
3
2019
Statut:
ppublish
Résumé
To compare the transpedal approach to established femoral approach for endovascular treatment of infrainguinal peripheral arterial disease. Endovascular treatment of infrainguinal peripheral arterial disease is on the rise. Femoral approach is widely used but has significant complications. Recently the primary transpedal approach has been described for endovascular interventions. We hypothesized that transpedal approach could reduce access site related complications. We compared the two approaches in a retrospective cross-sectional study at a single center. We analyzed demographics, procedural parameters, and complications in patients who underwent a primary transpedal approach for infrainguinal intervention and compared to patients with a traditional femoral approach in our outpatient based endovascular lab. The success rate for access was lower in transpedal group compared to femoral (94% vs. 100%, p = .0002). The contrast dose (44 ± 11 mL vs. 68 ± 13 mL, p < .0001), radiation dose (25 mGy [16-43] vs. 48 mGy [36-67], p < .0001) and fluoroscopy time (5.48 min [3.48-11.71] vs. 9.35 min [6.63-14.11], p < .0001) were significantly lower in transpedal group. The transpedal approach for infrainguinal revascularization appears to be a reasonable primary approach with high success and low complication rate with significant reduction in radiation and contrast dose. These findings should be further studied in a randomized controlled trial.
Sections du résumé
OBJECTIVE
OBJECTIVE
To compare the transpedal approach to established femoral approach for endovascular treatment of infrainguinal peripheral arterial disease.
BACKGROUND
BACKGROUND
Endovascular treatment of infrainguinal peripheral arterial disease is on the rise. Femoral approach is widely used but has significant complications. Recently the primary transpedal approach has been described for endovascular interventions. We hypothesized that transpedal approach could reduce access site related complications. We compared the two approaches in a retrospective cross-sectional study at a single center.
METHODS
METHODS
We analyzed demographics, procedural parameters, and complications in patients who underwent a primary transpedal approach for infrainguinal intervention and compared to patients with a traditional femoral approach in our outpatient based endovascular lab.
RESULTS
RESULTS
The success rate for access was lower in transpedal group compared to femoral (94% vs. 100%, p = .0002). The contrast dose (44 ± 11 mL vs. 68 ± 13 mL, p < .0001), radiation dose (25 mGy [16-43] vs. 48 mGy [36-67], p < .0001) and fluoroscopy time (5.48 min [3.48-11.71] vs. 9.35 min [6.63-14.11], p < .0001) were significantly lower in transpedal group.
CONCLUSION
CONCLUSIONS
The transpedal approach for infrainguinal revascularization appears to be a reasonable primary approach with high success and low complication rate with significant reduction in radiation and contrast dose. These findings should be further studied in a randomized controlled trial.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1311-1314Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 Wiley Periodicals, Inc.