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Comparison of transradial and transfemoral access for transcatheter arterial embolization of iatrogenic renal hemorrhage

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Abstract
Background There are few reports of renal artery embolization (RAE) via transradial access (TRA) for renal hemorrhage, and none have compared outcomes of RAE via TRA and transfemoral access (TFA). The objective was to compare technical and clinical outcomes in patients undergoing RAE via TRA or TFA for iatrogenic renal hemorrhage. Materials and methods This study included 45 RAE procedures (16 TRA and 29 TFA) for iatrogenic renal hemorrhage in 43 patients performed at a tertiary referral center between October 2018 and December 2020. Information regarding underlying diseases, coagulation status, angiographic and embolization procedure details, technical and clinical successes, and complications were retrospectively evaluated. Results There were no differences in demographics, underlying diseases, updated Charlson comorbidity scores, angiographic findings, and volume of contrast material between the TRA and TFA groups. By contrast, prothrombin time and international normalized ratio were significantly lower in the TRA than in the TFA group. Embolic materials differed significantly in the two groups. Procedure duration, fluoroscopy time, digital subtraction angiography number, and dose area product were slightly lower in the TRA than in the TFA group, but the differences were not statistically significant. Technical and clinical success rates in the TRA and TFA groups were 100% and 96.6%, and 100% and 96.6%, respectively. No patient in either group experienced procedure-related complications during a 4 week follow-up period. Conclusion RAE via TRA in the management of iatrogenic renal hemorrhage was safe and feasible, with similar procedure duration and radiation exposure to RAE via TFA. TRA may be an acceptable alternative to TFA in these patients.
Author(s)
고흥규김건하김소연님인출신지훈추희호Chuanwu CaoMeshari Alali
Issued Date
2021
Type
Article
Keyword
Acute Kidney InjuryAdultlAgedAngiography - methodsBlood clotCare and treatmentCatheterizationPeripheral - adverse effectsComplications and side effectsEmbolizationTherapeutic - methodsFemaleFemoral Artery - physiologyHemorrhageHemorrhage - etiologyHumansIatrogenic DiseaseKidney - pathologyMaleMedical errorsMiddle AgedPatient outcomesPuncturesRadial Artery - physiologyRetrospective StudiesThrombosisTime FactorsTreatment OutcomeVascular Surgical Procedures - methods
DOI
10.1371/journal.pone.0256130
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8312
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_5e79d7d50c7f46118af8d6cadd16435d&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Comparison%20of%20transradial%20and%20transfemoral%20access%20for%20transcatheter%20arterial%20embolization%20of%20iatrogenic%20renal%20hemorrhage&offset=0&pcAvailability=true
Publisher
PLOS ONE
Location
미국
Language
영어
ISSN
1932-6203
Citation Volume
16
Citation Number
8
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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