Transradial access for visceral endovascular interventions in morbidly obese patients: safety and feasibility.
Marinelli, Brett; O'Connor, Paul J.; Titano, Joseph J.; Patel, Rahul S.; Kim, Edward; Tabori, Nora E.; Nowakowski, Francis S.; Lookstein, Robert A.; Fischman, Aaron M.; Biederman, Derek M. *
[Article] The Journal of Vascular Access. 17(3):256-260, May 7, 2016.

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Purpose: Transradial access (TRA) has been shown to lower morbidity and bleeding complications compared to transfemoral access in percutaneous coronary interventions. Morbid obesity, commonly defined as a body mass index (BMI) >=40 kg/m2, has been shown to be a risk factor for access site complications irrespective of access site. This study evaluates the safety and feasibility of performing visceral endovascular interventions in morbidly obese patients via TRA.

Methods: Procedural details, technical success, and 30-day major and minor access site, bleeding, and neurological adverse events were prospectively recorded in a database of 1057 procedures performed via the radial artery. From this database we identified 22 visceral interventions performed with TRA in 17 morbidly obese patients (age: 53 /- 11 years, female: 71%) with a median BMI of 42.7 kg/m2.

Results: Interventions included radio-embolization (n = 7, 31.8%), chemo-embolization (n = 6, 27.3%), uterine fibroid embolization (n = 4, 18.2%), renal embolization (n = 2, 9.1%), hepatic embolization (n = 1, 4.5%), lumbar artery embolization (n = 1, 4.5%), and renal angioplasty (n = 1, 4.5%). The technical success was 100%. There were no major or minor adverse access site, bleeding, or neurological complications at 30 days.

Conclusions: This study suggests visceral endovascular interventions performed in morbidly obese patients are safe and feasible.

(C) 2016Wichtig Publishing - Milano (Italia)