CIO 2022-29 Radial Access in Patients with Small Radial Arteries

Purpose: Radial access is gaining acceptance as an effective method of performing trans-arterial oncologic interventions. Most guidelines recommend radial artery diameter smaller than 2mm as a relative contraindication for trans-radial vascular access. The purpose of this study is to evaluate a single institution’s experience with radial access in patients with a radial artery diameter less than 2mm.

Methods: This IRB-approved single center retrospective study included 26 patients (6 male, 20 female, age at procedure 64.4±14.4 years)
who underwent an average of 1.3±0.86 trans-arterial interventions using trans-radial access between September 2015 and March 2022. Patients were included if their radial artery diameter at the time of procedure was  less than 2mm. The procedures included chemoperfusion, radioembolization, bland embolization and angiography. Medical records and imaging data were reviewed to evaluate procedural success, complications and radial artery diameter.

Results: A total of 33 trans-radial procedures were performed in these 26 patients. The mean radial artery diameter was 1.65±0.24mm. The technical success rate of these procedures was 97%. The 1 failed procedure had a radial artery diameter of 1mm. No instances of radial artery occlusion were noted after trans-radial access. Only 1 complication occurred with a subcutaneous fluid collection at the right mid-forearm.

Conclusions: Trans-radial access is safe and effective in patients with radial artery diameters less than 2mm. Further study is needed to redefine the radial artery diameter that should serve as a relative contraindication to trans-radial access.