Comparison of the effects between trans radial approach and trans femoral approach in the interventional treatment of vertebral artery ostium stenosis

Objective To compare and analyze the safety and efficacy of interventional treatment via the trans radial approach(TRA) and trans femoral approach(TFA) for vertebral artery ostium stenosis(VAOS).

Methods A total of 55 patients treated with VAOS stent implantation from January 2023 to March 2024 were retrospectively analyzed, and divided into the TRA group(27 cases) and TFA group(28 cases) according to the approach.The baseline characteristics, surgical parameters(target vascular stenosis rate, puncture time, operation duration and residual stenosis rate), and postoperative recovery indicators(hospital stay, puncture site complications and 90-day prognosis score) between two groups were compared.

Results There was no statistical significance in the preoperative dataincluding the age, gender, BMI, related risk factors(hypertension, diabetes, smoking and drinking history), onset form, preoperative National Institutes of Health stroke scale(NIHSS) scores and modified Rankin scale(mRS) scores between two groups(P>0.05).In terms of surgical parameters, there was no statistical significance in the target vessel stenosis rates and puncture times between two groups(P>0.05).However, the operation duration in the TRA group was shorter than that in TFA group(P < 0.01), and the immediate postoperative residual stenosis in two groups were less than 5%.Regarding postoperative recovery, the length of hospital stay in the TRA group was shorter compared with that of TFA group(P < 0.01), and there was no statistical significance in the 90-day mRS and NIHSS scores between two groups(P>0.05).As for complications, there was no statistical significance in the overall complication rate between two groups(P>0.05).There was 1 case of pseudoaneurysm and 1 case of vasovagal reflex in the TFA group, while no such cases occurred in the TRA group.

Conclusions The effectiveness of TRA in treating VAOS is comparable to that of TFA, but TRA has advantages such as shorter operation time, faster postoperative recovery and fewer complications, and can be used as the preferred approach.