The study aims to understand the outcomes and incidences of cerebral embolic events while using left upper extremity access (LUE) and right upper extremity access (RUE) during f/bEVAR (fenestrated or branched endovascular aneurysm repair).

The study is a retrospective analysis of 290 patients enrolled in a study to understand f/bEVAR. 93% of the subjects had upper extremity access (12-F sheath). 205 patients were with LUE, and 65 were with RUE access. The metrics measured were procedural metrics, stroke or TIA, mortality, adverse events, and technical success.

The success rate was higher for LUE with 99.6% than 98.4% with RUE access. Subjects with RUE access were more likely to have extent I-III thoracoabdominal aortic aneurysms (57%) than 39% in LUE access. Procedural metrics like fluoroscopy time, endovascular time, and contrast volume were similar in both groups. LUE access had higher radiation exposure. There were two unrelated site complications leading to death. Major adverse events occurred in 32% of the subjects with LUE (26% of RUE). 2% had an embolic stroke, and TIA was absent. The stroke incidence was 3% in LUE and 2% in RUE.

There was no significant difference between the LUE and RUE approach.

Ref: https://journals.sagepub.com/doi/full/10.1177/1526602820953511