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Tsukagoshi J, Bhuyan A, Secemsky EA, Shirasu T, Nakama T, Jujo K, Wiley J, Kuno T. Procedural Feasibility and Peri-procedural Outcomes of Peripheral Endovascular Therapy via Transradial versus Transfemoral Access: A Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg 2024:S1078-5884(24)00650-6. [PMID: 39111535 DOI: 10.1016/j.ejvs.2024.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 06/30/2024] [Accepted: 07/31/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to evaluate the safety and feasibility of transradial access for peripheral vascular interventions. DATA SOURCES MEDLINE and Embase. REVIEW METHODS MEDLINE and Embase databases were searched to June 2023 to identify studies investigating the outcomes of lower extremity, carotid, and visceral artery vascular interventions via transradial vs. transfemoral access. The primary outcome was procedural failure rate. Secondary outcomes were total access site complications, minor and major bleeding, stroke, access vessel occlusion, procedure time, fluoroscopy time, and contrast volume. RESULTS Eight randomised controlled trials and 29 observational studies yielded a total of 70 882 patients treated via transradial (n = 2 616) vs. transfemoral access (n = 68 338). The overall failure rate was 2.3 ± 0.7%, and the transradial approach was associated with a statistically significantly higher procedural failure rate than the transfemoral approach (3.9 ± 0.7% vs. 1.0 ± 0.3%; odds ratio [OR] 3.07, 95% confidence interval [CI] 1.84 - 5.12; I2 = 32%; p < .001). Subgroup analysis showed the highest failure rate in lower extremity interventions with 12.4 ± 4.9% for transradial vs. 4.0 ± 1.2% for transfemoral access. Conversely, procedural complications were statistically significantly fewer with transradial access for total access site complications (OR 0.64, 95% CI 0.45 - 0.91; I2 = 36%; p = .010). Minor bleeding was statistically significantly less with the transradial approach (OR 0.52, 95% CI 0.31 - 0.86; I2 = 30%; p = .010), whereas major bleeding and stroke rates were similar. Transradial access had more access vessel occlusion than transfemoral access (1.9% ± 0.5% vs. < 0.1% ± 0.0%; p = .004), although most remained asymptomatic. Procedure time, fluoroscopy time, and contrast volume were all comparable. GRADE certainty was low to moderate in most outcomes. CONCLUSION The transradial approach was associated with a higher procedural failure rate. Total access site complications and minor bleeding were lower with the transradial approach, albeit with more frequent access vessel occlusion. Transradial access may be a feasible and safe approach; however, appropriate patient selection is imperative.
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Affiliation(s)
- Junji Tsukagoshi
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. https://twitter.com/jt_TeamWADA
| | - Arijit Bhuyan
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Eric A Secemsky
- Division of Cardiology, Beth Israel Deaconess Medical Centre, Boston, MA, USA. https://twitter.com/EricSecemskyMD
| | - Takuro Shirasu
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Centre, Urayasu, Japan. https://twitter.com/tatsuya_nakama
| | - Kentaro Jujo
- Department of Cardiology, Saitama Medical University, Iruma, Japan. https://twitter.com/jujo85553842
| | - Jose Wiley
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine, Los Angeles, CA, USA
| | - Toshiki Kuno
- Division of Cardiology, Montefiore Medical Centre, Albert Einstein College of Medicine, New York, NY, USA; Department of Cardiology, Jacobi Medical Centre, Albert Einstein College of Medicine, New York, NY, USA; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Hedjoudje M, Barat M, Dohan A, Lucas A, Dautry R, Coriat R, Marchese U, Pol S, Parlati L, Soyer P. Comparison Between Radial and Femoral Artery Access for Transarterial Chemoembolisation in Patients With Hepatocellular Carcinoma. Can Assoc Radiol J 2024; 75:178-186. [PMID: 37563785 DOI: 10.1177/08465371231186524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
PURPOSE The purpose of this study was to compare the technical success rate, the selectivity of transarterial chemoembolisation (TACE), the complication rate, the radiation dose given to the patients and the hospitalization stay between TACE performed using femoral artery approach (FAA) and TACE performed using radial artery approach (RAA) in patients with hepatocellular carcinoma (HCC). METHODS Between June 2020 and April 2022, 49 patients with HCC who underwent 116 TACEs (75 using FAA and 41 using RAA) were included. Differences in technical success rate, selectivity of micro-catheterization, radiation dose given to the patients, fluoroscopy time, hospitalization stay duration, and complication rate were compared between FAA and RAA using Fisher exact or Student t tests. RESULTS No differences in technical success rates were found between RAA (93%; 39/41 TACEs) and FAA (100%; 75/75 TACEs) (P = .12). There were no differences between the two groups in terms of selectivity of catheterization, radiation dose, fluoroscopy time and hospitalization stay duration. Five patients had Grade 2 complications (hematoma) after FAA vs. one patient with one Grade 1 complication (radial artery occlusion) after RAA (5/75 [7%] vs. 1/41 [2%], respectively; P = .42). No major arterial access site complications occurred with FAA or RAA. CONCLUSIONS This study confirms that RAA is a safe approach that does not compromise the technical efficacy and the selectivity of TACE compared to FAA in patients with HCC.
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Affiliation(s)
| | - Maxime Barat
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
| | - Anthony Dohan
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
| | - Alexandre Lucas
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
| | - Raphael Dautry
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
| | - Romain Coriat
- Faculté de Médecine, Université Paris Cité, Paris, France
- Department of Gastroenterology and Digestive Oncology, Hopital Cochin, AP-HP, Paris, France
| | - Ugo Marchese
- Faculté de Médecine, Université Paris Cité, Paris, France
- Department of Digestive, Hepatobiliary, and Endocrine Surgery, Hopital Cochin, AP-HP, Paris, France
| | - Stanislas Pol
- Faculté de Médecine, Université Paris Cité, Paris, France
- Department of Hepatology, Hopital Cochin, AP-HP, Paris, France
| | - Lucia Parlati
- Faculté de Médecine, Université Paris Cité, Paris, France
- Department of Hepatology, Hopital Cochin, AP-HP, Paris, France
| | - Philippe Soyer
- Department of Radiology, Hopital Cochin, AP-HP, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
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Yang M, Jiang S, Wang Y, Meng X, Guo L, Zhang W, Zhou X, Yan Z, Li J, Dong W. Chinese expert consensus on transradial access in percutaneous peripheral interventions. J Interv Med 2023; 6:145-152. [PMID: 38312127 PMCID: PMC10831370 DOI: 10.1016/j.jimed.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 02/06/2024] Open
Abstract
Transradial access (TRA) is a safe and comfortable approach and the preferred access for percutaneous coronary intervention. However, TRA is not widely used for peripheral interventions. Currently, there is a lack of data on patient selection, appropriate medical devices, complication prevention, and TRA adoption. Therefore, the Chinese Society of Interventional Oncology of the China Anti-Cancer Association organized nationwide experts to establish a Working Group of China Expert Consensus on TRA in percutaneous peripheral interventions in 2022, and jointly formulated this consensus to better promote the application of TRA in peripheral interventions to guide clinicians on patient selection, technical recommendations, and physician training. This consensus mainly focuses on the current situation, advantages and limitations of TRA in peripheral interventions, anatomical characteristics of the radial artery, patient selection, technical aspects, prevention and management of complications, radiation dose, and learning curve. A consensus was reached through a literature evaluation and by referring to the opinions of the expert group.
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Affiliation(s)
- Minjie Yang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Sen Jiang
- Department of Radiology, Shanghai Pulmonary Hospital, 507 Zhengmin Road, Yangpu District, Shanghai, China
| | - Yanli Wang
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, Zhengzhou, China
| | - Xiaoxi Meng
- Department of Interventional Radiology, Shanghai Changzheng Hospital, 415 Feng Yang Road, Huangpu District, Shanghai, China
| | - Liwen Guo
- Department of Interventional Radiology, Zhejiang Cancer Hospital, No.1 East Banshan Road, Gongshu District, Hangzhou, China
| | - Wen Zhang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Xin Zhou
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Zhiping Yan
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Jiarui Li
- Department of Interventional Radiology, The First Hospital of Jilin University, 71 Xinmin Street, Chaoyang District, Changchun, China
| | - Weihua Dong
- Department of Interventional Radiology, Shanghai Changzheng Hospital, 415 Feng Yang Road, Huangpu District, Shanghai, China
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Yakupoğlu A, Buturak ÖSU. Transradial Access for Transarterial Radioembolization (TARE) in Patients with Hepatocellular Carcinoma: Comparison with Transfemoral Access. Cardiovasc Intervent Radiol 2023; 46:1359-1364. [PMID: 37723353 DOI: 10.1007/s00270-023-03542-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/16/2023] [Indexed: 09/20/2023]
Abstract
PURPOSE To compare safety, efficacy, radiation exposure and patients comfort in patients of transradial access (TRA) in patients undergoing TARE compared with transfemoral access (TFA) including patient radiation exposure and patient comfort. METHODS A total of 222 patients undergoing technetium-99 m macro-aggregated albumin and TARE were retrospectively reviewed from 2017 to 2022. We analyzed procedure-related pain, quality of life, recovery time, procedure time, fluoroscopy time (FT), air kerma product and air kerma (AK) to compare the two access for intervention for HCC. RESULTS A total of 222 [(TFA (n = 147) and TRA (n = 75)] patients who underwent TARE for hepatocellular carcinoma (HCC) were included. No significant difference was found regarding FT and DAP in comparison of TRA and TFA. (p = 0.385, p = 0.842). While the mean AK was 892.7 mGy in TFA patients, it was 545.2 mGy in TRA patients and there was statistically significant difference (p = 0.017). Patients who underwent TRA had significantly shorter hospital stays, and recovery times compared to those who underwent TFA (p = 0.001, p = 0.001). In terms of both mental health and physical function, TRA versus TFA has been observed to produce more favorable outcomes (p = 0.044, p = 0.032). CONCLUSION TRA access for TARE procedures significantly enhances patient comfort and satisfaction. The total radiation dose exposed to the patients who underwent TRA access was found to be significantly lower than the patients who underwent TFA access.
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Affiliation(s)
- Abdullah Yakupoğlu
- Department of Interventional Radiology, Memorial Şişli Hospital, Istanbul, Turkey.
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Xiong J, Zhou Y, Tan K, Liu H, Cao Y, Liu J, Wu W, Du X, Luo Z. The feasibility and safety of the brachial artery approach in the treatment of hepatic artery infusion chemotherapy: a retrospective study. J Gastrointest Oncol 2023; 14:1830-1836. [PMID: 37720451 PMCID: PMC10502538 DOI: 10.21037/jgo-23-523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
Background Compared to hepatic artery infusion chemotherapy (HAIC) treatment through the femoral artery (TFA), the brachial artery (TBA) is more flexible and easier for patients to accept. However, the feasibility of TBA has not been studied yet. This study aims to evaluate the feasibility and safety of HAIC via the TBA. Methods We retrospectively reviewed the medical records of 63 patients with primary liver cancer who were treated with HAIC via TBA. In this study, a total of 163 HAIC procedures were performed via the left brachial artery pathway, and each patient underwent an average of 2.59 procedures. One patient received 5 treatments, 18 patients received 4 treatments, 15 patients received 3 treatments, 12 patients received 2 treatments, and 17 patients received 1 treatment. The main evaluation indicators were the technical success rate and complication rate. Results The main technical success rate was 99.4% (162/163). No patient required conversion to the femoral artery (TFA) access. All the complications were minor and occurred in 11 patients (6.75%). Subcutaneous ecchymosis occurred in 3 (1.84%) patients, arterial thrombosis in 2 patients (1.23%), and catheter displacement in 6 patients (3.68%). No serious complications occurred. Conclusions TBA pathway is feasible and safe for HAIC treatment of liver cancer patients. More research is needed in the future to confirm whether TBA is superior to other pathways.
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Affiliation(s)
- Jian Xiong
- Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Yanyan Zhou
- Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Kai Tan
- Department of General Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Haofeng Liu
- SenseTime Joint Lab of Smart Health Care, Xidian University, Xi’an, China
- School of Artificial Intelligence, Xidian University, Xi’an, China
| | - Yunbao Cao
- Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Junde Liu
- Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Wenhao Wu
- Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xilin Du
- Department of General Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Zhonghua Luo
- Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
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You K, Guo T, Sun D, Song H, Liu Z. Transradial versus transfemoral approach for TACE: a retrospective study. BMC Gastroenterol 2023; 23:11. [PMID: 36631744 PMCID: PMC9835221 DOI: 10.1186/s12876-023-02646-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Transcatheter arterial chemoembolization (TACE) has been widely applied in the treatment of hepatocellular carcinoma (HCC). Our study aimed to investigate the feasibility and efficacy of transradial access as an alternative to transfemoral access for TACE. METHODS Patients undergoing TACE were divided into the radial artery (RA) route group or the femoral artery (FA) route group according to the operation approach, namely, transradial or transfemoral access. We retrospectively analysed the clinical characteristics, technical outcomes, clinical efficacy and incidence of adverse events to compare the two technologies for intervention for HCC. RESULTS Transradial access was found to achieve superior technical outcomes and clinical efficacy, as the patients in the RA group had a lower rate of hepatic arterial spasm, a higher partial response rate and a lower progression rate than the patients in the FA group according to the mRECIST evaluations. In contrast, the liver function indices and VAS (visual analogue scale) pain scores were consistent across the two groups. Moreover, patients in the RA group had a shorter length of stay than those in the FA group, despite similar hospitalization expenses. The total adverse events were significantly reduced by transradial access for TACE (72.5% vs. 84.1%, P = 0.027). CONCLUSION Our study suggested that transradial access is an effective and feasible alternative to transfemoral access for TACE. Large-scale prospective randomized controlled studies are expected.
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Affiliation(s)
- Ke You
- grid.412461.40000 0004 9334 6536Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road 74, Chongqing, 400010 China
| | - Tao Guo
- grid.477425.7Liuzhou Key Laboratory of Infection Disease and ImmunologyGuangxi Health Commission Key Laboratory of Clinical Biotechnology, Liuzhou People’s Hospital affiliated to Guangxi Medical University, Liuzhou, 545006 China ,grid.268079.20000 0004 1790 6079Department of Pathophysiology, School of Basic Medical Sciences, Weifang Medical University, Weifang, 261053 China
| | - Da Sun
- Department of Organ Transplantation, Third Affiliated Hospital of Naval Military Medical University, North Moyu Road 700, Shanghai, 201805 China
| | - Hao Song
- Department of Organ Transplantation, Third Affiliated Hospital of Naval Military Medical University, North Moyu Road 700, Shanghai, 201805 China
| | - Zuojin Liu
- grid.412461.40000 0004 9334 6536Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road 74, Chongqing, 400010 China
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7
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Transradial versus transfemoral access for liver cancer patients undergoing hepatic arterial infusion chemotherapy: Patient experience and procedural complications. J Vasc Interv Radiol 2022; 33:956-963.e1. [DOI: 10.1016/j.jvir.2022.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/25/2022] [Accepted: 04/21/2022] [Indexed: 11/22/2022] Open
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Society of Interventional Radiology Quality Improvement Standards on Radial Artery Access. J Vasc Interv Radiol 2021; 32:761.e1-761.e21. [PMID: 33933252 DOI: 10.1016/j.jvir.2020.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/23/2022] Open
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Hobby S, Stroebel M, Yamada R, Johnson T, Uflacker A, Hannegan C, Guimaraes M. Transradial Access: A Comprehensive Review. VASCULAR AND ENDOVASCULAR REVIEW 2021. [DOI: 10.15420/ver.2020.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Transradial access (TRA) via the left radial artery is an alternative to traditional transfemoral access for catheter-based procedures that is becoming increasingly more relevant in all types of arterial vascular interventions. First investigated in the realm of cardiology, TRA has been proven to provide many benefits (such as lower complication rates, lower cost, and improved patient comfort during and after the procedure) when compared with traditional femoral access while maintaining efficacy. This article provides an in-depth summary of the technical aspects of radial access while incorporating more recent data to explain patient preference for TRA, and the ways that TRA can improve peri-procedure workflow and compensation. It also describes potential complications, such as radial artery spasm, difficult anatomic variants and radial artery occlusion, and then gives techniques for mitigating and treating these complications. The article explains why TRA has become an important option for vascular and interventional radiology physicians, and why it is likely that this will continue to grow in relevance.
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Affiliation(s)
- Shawn Hobby
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
| | - Maxwell Stroebel
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
| | - Ricardo Yamada
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
| | - Thor Johnson
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
| | - Andre Uflacker
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
| | - Christopher Hannegan
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
| | - Marcelo Guimaraes
- Vascular and Interventional Radiology Division, Medical University of South Carolina, Charleston, SC, US
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Terlouw LG, Moelker A, Abrahamsen J, Acosta S, Bakker OJ, Baumgartner I, Boyer L, Corcos O, van Dijk LJD, Duran M, Geelkerken RH, Illuminati G, Jackson RW, Kärkkäinen JM, Kolkman JJ, Lönn L, Mazzei MA, Nuzzo A, Pecoraro F, Raupach J, Verhagen HJM, Zech CJ, van Noord D, Bruno MJ. European guidelines on chronic mesenteric ischaemia - joint United European Gastroenterology, European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Gastrointestinal and Abdominal Radiology, Netherlands Association of Hepatogastroenterologists, Hellenic Society of Gastroenterology, Cardiovascular and Interventional Radiological Society of Europe, and Dutch Mesenteric Ischemia Study group clinical guidelines on the diagnosis and treatment of patients with chronic mesenteric ischaemia. United European Gastroenterol J 2020; 8:371-395. [PMID: 32297566 PMCID: PMC7226699 DOI: 10.1177/2050640620916681] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/08/2020] [Indexed: 12/24/2022] Open
Abstract
Chronic mesenteric ischaemia is a severe and incapacitating disease, causing complaints of post-prandial pain, fear of eating and weight loss. Even though chronic mesenteric ischaemia may progress to acute mesenteric ischaemia, chronic mesenteric ischaemia remains an underappreciated and undertreated disease entity. Probable explanations are the lack of knowledge and awareness among physicians and the lack of a gold standard diagnostic test. The underappreciation of this disease results in diagnostic delays, underdiagnosis and undertreating of patients with chronic mesenteric ischaemia, potentially resulting in fatal acute mesenteric ischaemia. This guideline provides a comprehensive overview and repository of the current evidence and multidisciplinary expert agreement on pertinent issues regarding diagnosis and treatment, and provides guidance in the multidisciplinary field of chronic mesenteric ischaemia.
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Affiliation(s)
- Luke G Terlouw
- Department of Gastroenterology and Hepatology, Erasmus MC
University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus MC University Medical Center,
Rotterdam, the Netherlands
| | - Adriaan Moelker
- Department of Radiology, Erasmus MC University Medical Center,
Rotterdam, the Netherlands
| | - Jan Abrahamsen
- Department of Clinical Physiology, Viborg Regional Hospital,
Viborg, Denmark
| | - Stefan Acosta
- Department of Clinical Sciences Malmö, Lund University, Lund,
Sweden
- Department of Cardio‐Thoracic and Vascular Surgery, Skane
University Hospital, Malmö, Sweden
| | - Olaf J Bakker
- Department of Vascular Surgery, Sint Antonius hospital,
Nieuwegein, the Netherlands
- Department of Vascular Surgery, University Hospital Leipzig,
Leipzig, Germany
| | - Iris Baumgartner
- Division of Angiology, Swiss Cardiovascular Center, Inselspital,
Bern University Hospital, University of Bern, Bern, Switzerland
| | - Louis Boyer
- Department of Diagnostic and Interventional Radiology, Montpied
University Hospital, Clermont‐Ferrand, France
| | - Olivier Corcos
- Department of Gastroenterology, Intestinal Stroke Center,
Hopital Beaujon APHP, Clichy, France
| | - Louisa JD van Dijk
- Department of Gastroenterology and Hepatology, Erasmus MC
University Medical Center, Rotterdam, the Netherlands
| | - Mansur Duran
- Department of Vascular and Endovascular Surgery, Marienhospital
Gelsenkirchen, Gelsenkirchen, Germany
| | - Robert H Geelkerken
- Department of Vascular Surgery, Medisch Spectrum Twente,
Enschede, the Netherlands
- Multi-modality Medical Imaging (M3I) group, Faculty of Science
and Technology, Technical Medical Centre, University of Twente, Enschede, the
Netherlands
| | - Giulio Illuminati
- Department of Surgical Sciences, University of Rome La
Sapienza, Rome, Italy
| | - Ralph W Jackson
- Department of Interventional Radiology, Newcastle upon Tyne
Hospitals NHS Foundation Trust, UK
| | - Jussi M Kärkkäinen
- Heart Center, Kuopio University Hospital, Kuopio, Finland
- Department of Vascular Surgery, Mayo Clinic, Rochester, MN,
USA
| | - Jeroen J Kolkman
- Department of Gastroenterology and Hepatology, Medisch Spectrum
Twente, Enschede, the Netherlands
- Department of Gastroenterology and Hepatology, University
Medical Center Groningen, Groningen, the Netherlands
| | - Lars Lönn
- Department of Radiology, University of Copenhagen, Copenhagen,
Denmark
| | - Maria A Mazzei
- Department of Medical, Surgical and Neuro Sciences, Diagnostic
Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena,
Italy
| | - Alexandre Nuzzo
- Department of Gastroenterology, Hopital Beaujon APHP, Clichy,
France
| | - Felice Pecoraro
- Department of Surgical Oncological and Oral Sciences,
University of Palermo, Vascular Surgery Unit, AOUP ‘P. Giaccone’ Palermo,
Palermo, Italy
| | - Jan Raupach
- Department of Radiology, University Hospital Hradec Kralove,
Hradec Kralove, Czech Republic
| | - Hence JM Verhagen
- Department of Vascular Surgery, Erasmus MC University Medical
Center, Rotterdam, the Netherlands
| | - Christoph J Zech
- Radiology and Nuclear Medicine, University of Basel, Basel,
Switzerland
| | - Desirée van Noord
- Department of Gastroenterology and Hepatology, Franciscus
Gasthuis and Vlietland, Rotterdam, the Netherlands
| | - Marco J Bruno
- Department of Gastroenterology and Hepatology, Erasmus MC
University Medical Center, Rotterdam, the Netherlands
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Adnan SM, Romagnoli AN, Martinson JR, Madurska MJ, Dubose JJ, Scalea TM, Morrison JJ. A Comparison of Transradial and Transfemoral Access for Splenic Angio-Embolisation in Trauma: A Single Centre Experience. Eur J Vasc Endovasc Surg 2020; 59:472-479. [DOI: 10.1016/j.ejvs.2019.11.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 10/26/2019] [Accepted: 11/21/2019] [Indexed: 01/29/2023]
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12
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van Dijk LJD, van Noord D, van Mierlo M, Bijdevaate DC, Bruno MJ, Moelker A. Single-Center Retrospective Comparative Analysis of Transradial, Transbrachial, and Transfemoral Approach for Mesenteric Arterial Procedures. J Vasc Interv Radiol 2019; 31:130-138. [PMID: 31771892 DOI: 10.1016/j.jvir.2019.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/19/2019] [Accepted: 08/25/2019] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To assess feasibility and safety of transradial access (TRA) compared with transfemoral access (TFA) and transbrachial access (TBA) for mesenteric arterial endovascular procedures. MATERIALS AND METHODS A retrospective cohort analysis was performed including all consecutive patients who underwent a mesenteric arterial procedure in a tertiary referral center between May 2012 and February 2018. Exclusion criteria were absence of data and lost to follow-up within 24 hours after the procedure. During the study period, 103 patients underwent 148 mesenteric arterial procedures (TBA, n = 52; TFA, n = 39; TRA, n = 57). Mean patient age was 64.3 years ± 13.3, and 91 patients (62%) were women. Primary outcomes were vascular access specified technical success rate and access site complication rate, as reported in hospital records. RESULTS Technical success rate specified for the vascular access technique did not differ between the 3 approaches (TBA 96%, TFA 87%, TRA 91%; TRA vs TBA, P = .295; TBA vs TFA, P = .112; TRA vs TFA, P = .524), and overall access site complication rate was not different between the 3 approaches (TBA 42%, TFA 23%, TRA 35%; TRA vs TBA, P = .439; TBA vs TFA, P = .055; TRA vs TFA, P = .208). However, more major access site complications were reported for TBA than for TRA or TFA (TBA 17%, TFA 3%, TRA 2%; TRA vs TBA, P = .005; TBA vs TFA, P = .026; TRA vs TFA, P = .785). CONCLUSIONS TRA is a safe and feasible approach for mesenteric arterial procedures comparable to TFA, but with a significantly lower major access site complication rate than TBA.
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Affiliation(s)
- Louisa J D van Dijk
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands; Department of Radiology, Erasmus MC University Medical Center, 's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands.
| | - Desirée van Noord
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands; Department of Gastroenterology and Hepatology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Minke van Mierlo
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands
| | - Diederik C Bijdevaate
- Department of Radiology, Erasmus MC University Medical Center, 's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands
| | - Marco J Bruno
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands; Department of Radiology, Erasmus MC University Medical Center, 's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands
| | - Adriaan Moelker
- Department of Radiology, Erasmus MC University Medical Center, 's Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands
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