Percutaneous Trans-Radial Intervention for Acute Thrombosis of Upper Arm Grafts: An Outpatient-Based, Effective, and Feasible Option

Purpose: To evaluate the efficacy, safety, and feasibility of an outpatient-based trans-radial intervention for acute thrombosis of upper arm graft. Materials and methods: A total of 101 trans-radial balloon angioplasty was performed in 63 patients with acute thrombosis of upper arm graft (29 males, 34 females; age: 69 10 years). Thrombus was macerated and pushed into the central circulation with a balloon catheter. Low-dose urokinase injection was given as an adjunctive therapy in 17 interventions. Procedure time, anatomical and clinical success, and complications were analyzed. Results: The procedural time was 56+/-29 minutes. Anatomic success (< 30% residual stenosis) was obtained in 87.2% of cases and clinical success in 79.2%. There was no major bleeding or symptomatic pulmonary embolism. Other complications were distal arterial embolism with or without clinical symptoms in 2% and 5.9% of cases, respectively. The complication rate of axillary extravasations was 3%. Conclusion: Trans-radial intervention for acute thrombosis of upper arm graft as an outpatient procedure had comparable success and complications compared to the results reported earlier. Therefore, outpatient-based transradial intervention should be considered a feasible therapy for acute thrombosis of upper arm graft.