Transradial Arterial Access: Gastrointestinal Interventions

Introduction Transradial access (TRA) has been used extensively for coronary intervention and offers many advantages over the transfemoral access (TFA). When compared with TFA, TRA has been shown to be safer, associated with decreased hemorrhagic complications, decreased costs, and increased patient satisfaction. TRA is particularly useful in outpatient procedures because it allows for shorter patient recovery time and decreased risk of hematoma formation compared with TFA.

Content Organization This educational exhibit will discuss the clinical indications, patient selection criteria, and contraindications of TRA. A brief description of the procedure will highlight key differences of TRA from TFA including patient positioning, antispasmodic intra-arterial medication administration, and unique equipment used.

The benefits of TRA will be cited from the literature including decreased bleeding risks, length of hospital stay, and procedural cost compared with TFA. Disadvantages of TRA compared with other traditional access sites will also be discussed including difficulty due to small vessel size and the cumbrousness of the procedure for first time users.

The importance of thorough training of interventionalists, technologists, and nursing staff will also be noted, particularly for intra-arterial medication administration and successful post procedure hemostasis. Additionally, potential adverse events of TRA will be discussed as well as post procedural management.

A pictorial review will demonstrate hepatic, mesenteric, and splenic arterial interventions achieved via TRA with a brief description of each clinical case performed at our institution.

Learning Points In this educational exhibit, we will explore the option of using TRA access over TFA in gastrointestinal arterial-related procedures, including advantages and disadvantages of TRA access, access technique, and complications, as well as examples of GI interventions using radial access.