BRACHIAL-ARTERY ACCESS FOR PERCUTANEOUS RENAL-ARTERY INTERVENTIONS

Purpose: To evaluate the suitability of transbrachial access for endov ascular renal artery interventions. Methods: During 37 consecutive end ovascular renal artery interventions, the transbrachial approach was u sed on nine patients (mean age 63 years; range 41-76 years) for 11 ren al artery procedures on native kidneys and one percutaneous translumin al angioplasty (PTA) on a transplanted kidney. The reason for using tr ansbrachial access was a steep aorta renal angle in five, and severe a orta-iliac atherosclerosis in the remaining patients. In addition to t he intervention catheter in the left brachial artery, an additional no nselective catheter for controlling the procedure was inserted transfe morally (six patients) or via the contralateral brachial artery. Resul ts: Eleven interventions (six. PTAs, five stents) were successfully co mpleted. The one failure resulted from impenetrable subclavian artery stenosis. The only major complication was a brachial artery pseudoaneu rysm requiring surgical treatment. Conclusion: Transbrachial access is an effective and relatively safe technique for renal artery intervent ions when transfemoral access is not possible.