Cargando…

Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature

The transfemoral approach (TFA) or transradial approach (TRA) serves as the primary technique for most endovascular cases; however, the transbrachial (TBA) route is an alternative access site used when TFA and TRA are contraindicated. Although TBA has advantages over TRA, such as the ability to acco...

Descripción completa

Detalles Bibliográficos
Autores principales: Mantripragada, Koushik, Abadi, Kevin, Echeverry, Nikolas, Shah, Sumedh, Snelling, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278800/
https://www.ncbi.nlm.nih.gov/pubmed/35844321
http://dx.doi.org/10.7759/cureus.25894
_version_ 1784746264603131904
author Mantripragada, Koushik
Abadi, Kevin
Echeverry, Nikolas
Shah, Sumedh
Snelling, Brian
author_facet Mantripragada, Koushik
Abadi, Kevin
Echeverry, Nikolas
Shah, Sumedh
Snelling, Brian
author_sort Mantripragada, Koushik
collection PubMed
description The transfemoral approach (TFA) or transradial approach (TRA) serves as the primary technique for most endovascular cases; however, the transbrachial (TBA) route is an alternative access site used when TFA and TRA are contraindicated. Although TBA has advantages over TRA, such as the ability to accommodate large guide catheters and devices, there is some apprehension in implementing TBA due to perceived access site complication rates. This article aims to glean the rate of access site complication from current literature. Relevant studies were identified using the following search terms: ((access site complications) AND ((endovascular AND brachial) OR (percutaneous brachial access) OR (brachial))) OR (endovascular AND (percutaneous brachial access)); endovascular + brachial artery; endovascular + brachial artery + access site; and endovascular + brachial artery + access site complications. Articles published after 2008 addressing major complication rates from percutaneous TBA interventions were included. Fifteen studies out of 992 total articles met the inclusion criteria. The major access site complication rate was 75/1,424 (5.27%). Patients who underwent hemostasis with a vascular closure device (VCD) had a major complication rate of 13/309 (4.21%) compared to a major complication rate of 65/1122 (5.79%) for patients who underwent hemostasis with manual compression (MC). The major access site complication rate associated with TBA was 5.27%, which is relatively high compared to the complication rate in TFA or TRA. More prospective trials are needed to fully understand the access site complication rate in TBA interventions.
format Online
Article
Text
id pubmed-9278800
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-92788002022-07-14 Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature Mantripragada, Koushik Abadi, Kevin Echeverry, Nikolas Shah, Sumedh Snelling, Brian Cureus Cardiac/Thoracic/Vascular Surgery The transfemoral approach (TFA) or transradial approach (TRA) serves as the primary technique for most endovascular cases; however, the transbrachial (TBA) route is an alternative access site used when TFA and TRA are contraindicated. Although TBA has advantages over TRA, such as the ability to accommodate large guide catheters and devices, there is some apprehension in implementing TBA due to perceived access site complication rates. This article aims to glean the rate of access site complication from current literature. Relevant studies were identified using the following search terms: ((access site complications) AND ((endovascular AND brachial) OR (percutaneous brachial access) OR (brachial))) OR (endovascular AND (percutaneous brachial access)); endovascular + brachial artery; endovascular + brachial artery + access site; and endovascular + brachial artery + access site complications. Articles published after 2008 addressing major complication rates from percutaneous TBA interventions were included. Fifteen studies out of 992 total articles met the inclusion criteria. The major access site complication rate was 75/1,424 (5.27%). Patients who underwent hemostasis with a vascular closure device (VCD) had a major complication rate of 13/309 (4.21%) compared to a major complication rate of 65/1122 (5.79%) for patients who underwent hemostasis with manual compression (MC). The major access site complication rate associated with TBA was 5.27%, which is relatively high compared to the complication rate in TFA or TRA. More prospective trials are needed to fully understand the access site complication rate in TBA interventions. Cureus 2022-06-13 /pmc/articles/PMC9278800/ /pubmed/35844321 http://dx.doi.org/10.7759/cureus.25894 Text en Copyright © 2022, Mantripragada et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Mantripragada, Koushik
Abadi, Kevin
Echeverry, Nikolas
Shah, Sumedh
Snelling, Brian
Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature
title Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature
title_full Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature
title_fullStr Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature
title_full_unstemmed Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature
title_short Transbrachial Access Site Complications in Endovascular Interventions: A Systematic Review of the Literature
title_sort transbrachial access site complications in endovascular interventions: a systematic review of the literature
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278800/
https://www.ncbi.nlm.nih.gov/pubmed/35844321
http://dx.doi.org/10.7759/cureus.25894
work_keys_str_mv AT mantripragadakoushik transbrachialaccesssitecomplicationsinendovascularinterventionsasystematicreviewoftheliterature
AT abadikevin transbrachialaccesssitecomplicationsinendovascularinterventionsasystematicreviewoftheliterature
AT echeverrynikolas transbrachialaccesssitecomplicationsinendovascularinterventionsasystematicreviewoftheliterature
AT shahsumedh transbrachialaccesssitecomplicationsinendovascularinterventionsasystematicreviewoftheliterature
AT snellingbrian transbrachialaccesssitecomplicationsinendovascularinterventionsasystematicreviewoftheliterature