Introduction:

Radial or brachial access for endovascular treatment of peripheral arterial disease may reduce access site complications and avoid the need for post-procedure immobilization.

Aim:

This study evaluated in-hospital, 30-day, and 12-month outcomes for iliac artery lesion treatment with these access types.

Material and methods:

The study retrospectively included 109 patients, 67% males, aged 38-88 years, with chronic lower limb ischemia and atherosclerotic lesions in the iliac arteries. Endovascular treatment was performed via radial or brachial access in 22% and 78% of cases. Iliac artery occlusions, subocclusions, and significant stenoses were present in 11%, 24%, and 65% of patients. We collected data on demographics, comorbidities, procedural details, adverse events, and outcomes.

Results:

During the hospital stay and 30-day follow-up, there were no deaths, amputations, or reinterventions. Technical success was achieved in 100% of cases, with no conversions to femoral access required. The overall complication rate related to the access site was 4.6%, with 3.6% of complications necessitating local surgical intervention. Notably, there was one minor ischemic stroke and one distal embolization during using right brachial access. All reported access site complications were associated with brachial access. The average time to discharge after the procedure was 1.2 days. At 12 months, the target lesion revascularization rate was 3.7%.

Conclusions:

Radial or brachial access was a safe alternative to femoral access for endovascular procedures in the iliac arteries. Using left-side radial or brachial access enabled 100% technical success.