• World Neurosurg · Jan 2024

    Comparison of transradial access and transfemoral access for diagnostic cerebral angiography in the elderly population.

    • Yang Gao, Bin Liu, Hantao Yang, Guiping Wang, Jinlong Huang, Chen Li, Puyuan Zhao, Liangliang Yang, and Zhigang Yang.
    • Department of Neurosurgery, Zhongshan Hospital Fudan University, Shanghai, China.
    • World Neurosurg. 2024 Jan 1; 181: e411e421e411-e421.

    ObjectiveEvaluate the efficacy, safety, and patient satisfaction of transradial access (TRA) compared with conventional transfemoral access (TFA) for diagnostic cerebral angiography in elderly patients (≥65 years of age).MethodsWe performed a retrospective review of patients receiving cerebral angiography via TRA or TFA between October 2020 and December 2021 at 3 institutions. Basic patient characteristics, angiographic data, postoperative complications, and patient satisfaction were collected for analysis.ResultsOf the 357 enrolled elderly patients, 175 were performed through TRA and 182 were performed through TFA. There was no significant difference in mean fluoroscopy time (8.6 ± 3.8 minutes vs. 9.1 ± 3.1 minutes; P = 0.103) and radiation exposure (47.7 ± 10.8 Gy-cm2 vs. 49.8 ± 11.3 Gy-cm2; P = 0.068) between the TRA and TFA groups. However, the TRA group had a shorter procedural time (54.7 ± 6.2 minutes vs. 61.1 ± 5.6 minutes; P < 0.001) and less contrast agent (83.2 ± 28.1 mL vs. 100.1 ± 26.2 mL; P < 0.001) than the TFA group. In terms of safety, the incidence of minor vascular access complications in the TRA group was lower than that in the TFA group (1.7% vs. 8.8%; P = 0.003). The incidence of serious complications and neurologic complications in the TRA group was also lower, although the difference was not statistically significant. Overall patient satisfaction was higher in the TRA group than that in the TFA group.ConclusionsTRA was an efficient and safe alternative to conventional TFA in elderly patients who underwent diagnostic cerebral angiography and who underwent TRA were more satisfied. Findings supported the radial-first strategy for cerebral angiography in elderly populations.Copyright © 2023 Elsevier Inc. All rights reserved.

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