Comparison of transradial access and transfemoral access for diagnostic cerebral angiography in the elderly population.

OBJECTIVE: Evaluate the efficacy, safety, and patient satisfaction of transradial access (TRA) compared with conventional transfemoral access (TFA) for diagnostic cerebral angiography in elderly patients (≥65 years of age).

METHODS: We performed a retrospective review of patients receiving cerebral angiography via TRA or TFA between October 2020 and December 2021 at three institutions. Basic patient characteristics, angiographic data, postoperative complications, and patient satisfaction were collected for analysis.

RESULTS: Of the 357 enrolled elderly patients, 175 were performed through TRA and 182 were performed through TFA. There was no significant difference in mean fluoroscopy time (8.6±3.8 min versus [vs.] 9.1±3.1 min; p=0.103) and radiation exposure (47.7±10.8 Gy-cm2 vs. 49.8±11.3 Gy-cm2 ; p=0.068) between the TRA and TFA groups. However, the TRA group had a shorter procedural time (54.7±6.2 min vs. 61.1±5.6 min; p<0.001) and less contrast agent (83.2±28.1 ml vs. 100.1±26.2 ml; p<0.001) than the TFA group. In terms of safety, the incidence of minor vascular access complications in the TRA group was lower than that in the TFA group (1.7% vs. 8.8%; p=0.003). The incidence of serious complications and neurological complications in the TRA group was also lower, although the difference was not statistically significant difference. Overall patient satisfaction was higher in the TRA group than that in the TFA group.

CONCLUSIONS: TRA was an efficient and safe alternative to conventional TFA in elderly patients who underwent diagnostic cerebral angiography, and who underwent TRA were more satisfied. Findings supported the radial-first strategy for cerebral angiography in elderly populations.