• Zoltán Ruzsa, Robert Bellavics, Balázs Nemes, Artúr Hüttl, András Nyerges, Péter Sótonyi, Olivier Francois Bertrand, Kálmán Hüttl, and Béla Merkely.
• Semmelweis University of Budapest, Heart and Vascular Center, Budapest, Hungary; Bács-Kiskun County Hospital, Cardiology Division, Invasive Cardiology, Kecskemét, Hungary. Electronic address: zruzsa25@gmail.com.
• JACC Cardiovasc Interv. 2018 Jun 11; 11 (11): 1062-1071.

ObjectivesThe purpose of this prospective study was to evaluate the acute success and complication rates of combined transradial and transpedal access for femoral artery intervention.BackgroundImproved equipment and techniques have resulted in transition from transfemoral to transradial access for intervention of superficial femoral artery.MethodsBetween 2014 and 2016, clinical and angiographic data from 145 consecutive patients with symptomatic superficial femoral stenosis, treated via primary radial access using the 6-F SheathLess Eaucath PV guiding catheter were evaluated in a pilot study. Secondary access was achieved through the pedal or popliteal artery. The primary endpoints were major adverse events, target lesion revascularization, and rates of major and minor access-site complications. Secondary endpoints included angiographic outcome, procedural factors, crossover rate to femoral access site, and duration of hospitalization.ResultsTechnical success was achieved in 138 patients (95.2%). Combined radial and pedal access was obtained in 22 patients (15.1%). The crossover rate to a femoral access site was 2%. Stent implantation was necessary in 23.4% of patients. Chronic total occlusion recanalization was performed in 63 patients, with a 90.4% technical success rate. The mean contrast consumption, radiation dose, and procedure time were 112.9 ml (101.8 to 123.9 ml), 21.84 Gy/cm2 (9.95 to 33.72 Gy/cm2), and 34.9 min (31.02 to 38.77 min), respectively. The cumulative rate of access-site complications was 4.8% (0% major, 4.8% minor). The cumulative incidence rates of major adverse events at 3 and 12 months follow-up was 8.3% and 19.2%. The cumulative incidence rates of death at 3- and 12-month follow-up were 2.8% and 5.6%.ConclusionsFemoral artery intervention can be safely and effectively performed using radial and pedal access with acceptable morbidity and a high technical success rate.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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