A Prospective Comparison of Transradial and Transfemoral Approaches for Diagnostic Cerebral Angiography

Abstract

Digital subtraction angiography (DSA) is the gold standard method for examining patients with cerebrovascular diseases. Traditionally transfemoral route is chosen for cerebral DSA; however, it is associated with many complications. Many studies in the field of cardiology have shown the transradial approach (TRA) to be a valid alternative. Hence, the purpose of this study is to compare TRA and transfemoral approaches (TFAs) for diagnostic cerebral DSA concerning the procedure time, safety, and patient satisfaction.

Patients with features suggestive of cerebrovascular disease undergoing cerebral DSA were included in this study. Both approaches were compared, with respect to the success, procedure time, radiation exposure, and patient satisfaction along with the complications, if any.

We found that the total procedure time was significantly lower in TFA group (p-value <0.001) when compared with TRA group. The total fluoroscopy time was significantly lower in TFA group (p-value <0.001) and consequently had lower total radiation exposure (p-value 0.006) as compared with TRA group. There was no failure to complete the procedure in any of the subjects in the TFA group. On the other hand, the procedure could not be completed in three subjects (4.5%) in the TRA group. There were no complications in either group.

We concluded that in the TFA group, the procedure was completed significantly faster, the total fluoroscopic time was lower, and consequently, had lower radiation exposure as well. However, both procedures were comparable with respect to their success rate, complications, as well as patient satisfaction.