Transradial Approach to Treat Superficial Femoral Artery in-Stent Restenosis

Background: Transradial access reduces the incidence of access site complications of percutaneous revascularization procedures. However, in patients with peripheral vascular disease, the adoption of transradial approach for superficial femoral artery (SFA) angioplasty is usually prevented by the distance between the vascular access and the target lesions, thus SFA angioplasty is commonly performed by transfemoral approach. Recently, low-profile balloons with extended shaft length became available allowing to potentially address SFA lesions by transradial approach. As plain balloon angioplasty represents a valuable option for SFA in-stent restenosis treatment, we evaluated the feasibility of transradial approach in this clinical setting. Methods: Transradial balloon angioplasty of SFA diffuse in-stent restenosis was attempted in 12 patients aged 69.4+5.1years. Six-French 125 cm long MP guiding catheters, 300 cm long 0.018 guidewire and low-profile 4 Fr compatible 180 cm long shaft balloons (5 and 6 mm in diameter and 80 to 150 mm in length) were used. Results: The procedural success was 100% and no complications occurred during the hospital stay. Compared to a matched group of patients in whom angioplasty was performed by trans-femoral approach, main procedural key data resulted similar except for the amount of administered contrast dye which was slightly but significantly lower in transradial group (170+59 ml vs 241+103, p= 0.03). Conclusion: In conclusion, with the currently available equipment, the transradial approach is feasible and represents a valuable alternative for treatment of patients with SFA in-stent restenosis.