Abstract:

Comparative analysis of transradial and transfemoral approach for uterine artery embolization is presented.

Materials and methods: for the period from september 2013 to december 2014, 58 women underwent uterine artery embolization (UAE). Age varied from 25 to 49. Transradial approach (TRA) was used in 26 patients (44,8%), transfemoral approach (TFA) - in 32 patients (55,2%).

Results: uterine artery embolization was successful in all patients in both groups. Operation duration was 20,7 minutes in TRA group and 26,3 in TFA group (p>0,05). Mean number of used catheters was lower in TRA group (1,2 and 2,3 respectively p>0,02). In early post-operative period there was no complication in access place in TRA group, in 2 cases (7,7%) small subcutaneous hematomas were noted. They didn't require any special treatment. In TFA group, in 1 case (3.1%) it was noted the presence of hematoma, 5 cm in diameter, and in 4 cases (12,5%) - there were small subcutaneous hematomas that didn't require any special treatment. The usage of TRA is associated with a statistically significant reduction in the incidence of all parameters of discomfort, associated with UAE and improving the quality of life of patients in the early post-operative period compared with TFA. Significantly more often in patients with TRA group compared to the group TFA completely absent from the discomfort associated with the procedure (61.5% and 6.25%, respectively, p <0,001).

Conclusions: the use of TRA allowed to decrease an average of 29.6% of total duration of the intervention, decrease up to 51.5% of time spent on the uterine artery catheterization and 40.8% patient radiation dose. In addition, TRA allowed early mobilization of patients and reduced by 59% the incidence of discomfort associated with the UAE.  

References

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9.     Tavris D.R., Gallauresi B.A., Lin B. et al. Risk of local adverse events following cardiac catheterisation by hemostasis device use and gender. J. Invasive Cardiol. 2004; 16(9): 459-464.

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Sherev D.A., Shaw R.E., Brent B.N. Angiographic predictors of femoral access site complications: implication for planned percutaneous coronary intervention. Catheter Cardiovasc. Interv. 2005; 65(2): 196-202.

Abstract:

The article is devoted to one of the most modern methods of treatment of benign prostatic hyperplasia (BPH) - endovascular prostatic artery embolization (PAE). This kind of intervention is performed, usually, with approach through the common femoral artery Transradial vascular approach has many advantages over the femoral approach, but its use in this type of intervention is currently limited.

Aim: was to conduct a comparative analysis of the use of transradial and transfemoral vascular approach when performing PAE.

Materials and methods: in a group of transradial approach included 24 patients, and in the femoral approach group - 23 patients

Results: success rate of the procedure and the frequency of complications of vascular approach were comparable between groups. The total duration of the procedure, the time spent on catheterization of internal iliac and prostatic arteries, radiation exposure dose were significantly lower in the group of transradial approach. Using the transradial approach is associated with a significant reduction in the incidence and severity of the discomfort associated with the procedure.

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8.     Worthington-Kirsch R.L., Andrews R.T., Siskin G.P. et al. Uterine fibroid embolization: technical aspects. Tech. Vasc. Interv. Radiol. 2002;5:17-34.

9.     Carnevale F.C., da Motta-Leal-Filho J.M., Antunes A.A. et al. Quality of life and symptoms relief support prostatic artery embolization for patients with acute urinary retention due to benign prostatic hyperplasia. J. Vasc. Interv. Radiol. 2012;24:535-542.

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11.   Mclvor J., Rhymer J.C. 245 transaxillary arteriograms in arteriopathic patients: success rate and complications. Clin. Radiol. 1992;45(6):390-394.

12.   Jolly S.S., Yusuf S., Cairns J. et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011; 377(9775):1409-1420.

13.   Tavris D.R., Gallauresi B.A., Lin B. et al. Risk of local adverse events following cardiac catheterisation by hemostasis device use and gender. J. Invasive Cardiol. 2004; 16(9):459-464.

14.   Kanei Y, Kwan T., Nakra N.C. et al. Transradial cardiac catheterization: A review of access site complications. Catheter Cardiovasc. Interv. 2011;78(6):840-846.

15.   Caputo R.P, Tremmel J.A., Rao S. et al. Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Catheter Cardiovasc. Interv. 2011;78(6):823-839.

16.   Sherev D.A., Shaw R.E., Brent B.N. Angiographic predictors of femoral access site complications: implication for planned percutaneous coronary intervention. Catheter Cardiovasc. Interv. 2005;65(2):196-202.