Right Radial Artery Access for Visceral Embolizations – 30-day Outcomes

There is a lack of information on the use of right radial access (RA) in interventional radiology. This study is a retrospective evaluation of the safety and efficacy of right radial artery access for visceral embolizations.


Materials and Methods:

We performed a retrospective analysis of 139 visceral embolization interventions performed via right RA in 89 patients between January 1, 2021, and June 21, 2024. The indications included 97 primary or metastatic liver cancers (PMLC) (69%), 15 uterine interventions (UI) (11%), 12 acute bleedings (AB) (9%), and 15 other non-emergent indications (ONEI) (11%). The mean age at the time of procedure was 61 years, and 58% of cases were males. For clot and spasm prevention, 5000IU Heparin, 200mcg Nitroglycerine, and 2.5mg Verapamil were used. Procedure success was defined as completing the intended procedure using only right radial access. The primary safety endpoints were death, symptomatic stroke, hand ischemia, and access site complications within 30 days after the procedure. Clinical information was collected from the patients’ discharge and follow-up clinic notes.



Results:

Procedure success was 99% (137/139). By procedure category, success was 99% PMLC, 100% UI, 100% AB, and 93% ONEI. There were 9 deaths within 30 days, with 7/9 (78%) occurring in inpatients treated for active bleeding. None of the patients had symptomatic stroke or hand ischemia. There was 1 case of radial-to-femoral conversion because of an occluded mid-radial artery discovered after access, and 1 case was aborted due to uncontrollable vomiting. There was 1 access site complication (1%) related to a self-limited hematoma.



Conclusion:

Right RA seems to be a safe and effective approach for a variety of embolization procedures with a 99% procedural success. There was no symptomatic stroke or hand ischemia at 30 days.