Distal Radial access for SIRT procedures: A single center, retrospective analysis of 56 cases

Abstract

Purpose: The distal radial approach (anatomic snuffbox) has been increasingly used as an access point for arterial interventions. Distal radial access enhances patient comfort and minimizes hospital stay for SIRT procedures, by allowing immediate ambulation and precluding potential complications associated with proximal TRA orTFA. The aim of this study is to report our initial experience using distal radial access for SIRT. Material(s) and Method(s): Between August 2024 and March 2025, a total of 56 procedures, including planning angiograms - MAA infusions (n=30) and Y90 treatments (n=26), were performed for 30 patients, male 25 and female 5, aging from 35 to 82 years old (mean age, 64.1 years). Of the patients who received Y90 treatment, 18 had SIRT performed with the use of permanent, single-use implant of Y90 resin microspheres while 8 had SIRT performed with the use of millions of small glass microspheres containing radioactive Y90. Technical success, procedural details and access-related complications were noted after intervention. Major or minor adverse events noted at 30 days and evaluated. Result(s): Technical success was achieved in 55 of 56 cases (98.2%). The mortality rate was 0% at 30 days. Patients had undergone between zero and four previous TRA procedures. TRA complications, such as RA occlusion, nerve injury or bruising did not occur. One patient developed a 2nd grade hematoma, that required no further treatment. Conclusion(s): The distal radial access (anatomic snuffbox) for SIRT therapies appears to be safe and feasible, further decreasing access related complications, compared to proximal TRA orTFA.