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Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia

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Abstract

Purpose

Transradial access (TRA) has shown lower morbidity and decreased bleeding complications compared to transfemoral access. This study evaluates the safety and feasibility of TRA in thrombocytopenic patients undergoing visceral interventions.

Methods and Materials

Patients who underwent visceral interventions via the radial artery with platelet count less than or equal to 50,000/µL were included in the study. Outcome variables included technical success, access site, bleeding, transfusion, and neurological complications.

Results

From July 1, 2012, to May 31, 2015, a total of 1353 peripheral interventions via TRA were performed, of which 85 procedures were performed in 64 patients (mean age 62.2 years) with a platelet count <50,000/µL (median 39,000/µL). Interventions included chemoembolization (n = 46), selective internal radiation therapy (n = 30), and visceral embolization (n = 9). Technical success was 97.6 % with two cases of severe vessel spasm requiring ipsilateral femoral crossover. There was no major access site, bleeding, or neurological adverse events at 30 days. Minor access site hematomas occurred in five cases (5.9 %) and were treated conservatively in all cases. Pre-procedural platelet transfusions were administered in 23 (27.1 %) cases. There was no statistically significant difference in access site or bleeding complications between the transfused and nontransfused groups.

Conclusions

Transradial visceral interventions in patients with thrombocytopenia are both feasible and safe, possibly without the need for platelet transfusions.

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Authors and Affiliations

  1. Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA

    J. J. Titano, D. M. Biederman, B. S. Marinelli, R. S. Patel, E. Kim, N. E. Tabori, F. S. Nowakowski, R. A. Lookstein & A. M. Fischman

Authors
  1. J. J. Titano
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  2. D. M. Biederman
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  3. B. S. Marinelli
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  4. R. S. Patel
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  5. E. Kim
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  6. N. E. Tabori
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  7. F. S. Nowakowski
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  8. R. A. Lookstein
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  9. A. M. Fischman
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Corresponding author

Correspondence to A. M. Fischman.

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Conflict of interest

J J. Titano, D.M. Biederman, B.S. Marinelli, N.E. Tabori, F.S. Nowakowski: Nothing to disclose; R.S. Patel: Consultant: Sirtex Medical Ltd, Reverse Medical Corp; Speaker’s Bureau: Penumbra, Inc., St. Jude Medical, Inc., Terumo Interventional Systems; E. Kim: Consultant: Onyx Pharmaceuticals; Advisory Board: Onyx Pharmaceuticals, BTG International Ltd; Speaker’s Bureau: BTG International Ltd; R.A. Lookstein: Consultant: Boston Scientific Corporation, Cordis Corp, MEDRAD Interventional/Possis Partnership; Advisory Board: Boston Scientific Corporation; A.M. Fischman: Consultant: Surefire Medical, Terumo Interventional Systems; Advisory Board: Terumo Interventional Systems; Speaker’s Bureau: NeuWave Medical, Surefire Medical, Terumo Interventional Systems.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Titano, J.J., Biederman, D.M., Marinelli, B.S. et al. Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia. Cardiovasc Intervent Radiol 39, 676–682 (2016). https://doi.org/10.1007/s00270-015-1264-3

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  • DOI: https://doi.org/10.1007/s00270-015-1264-3

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