Efficacy and safety of bilateral radial versus femoral artery approaches for subclavian artery stenting: a single-center retrospective study.

OBJECTIVE

To compare the efficacy and safety of the bilateral radial artery versus femoral artery approach for subclavian artery stenting.

METHODS

This retrospective study included 126 patients who underwent subclavian artery stenting at the First People's Hospital of Zigong between January 2019 and December 2024. Patients were divided into a bilateral radial artery group (n=63) and a femoral artery group (n=63). Baseline data, perioperative outcomes, and complications were compared. Effectiveness indicators included procedural success, radiation dose, operative time, postoperative pain score, hospital stay, and total cost. Safety outcomes included composite perioperative events (death, stroke, myocardial infarction, or major bleeding) and puncture site complications.

RESULTS

All procedures were successfully completed without conversion. Compared to the femoral approach, the bilateral radial approach was associated with shorter operation time, reduced radiation exposure, lower postoperative pain, shorter postoperative hospital stay, and decreased total hospitalization cost (all P<0.05). No composite endpoint events occurred in either group. Puncture site complications were significantly lower with the bilateral radial approach (4.8% vs. 19.0%, P=0.028).

CONCLUSION

Subclavian artery stenting by the bilateral radial artery approach demonstrates equivalent efficacy and superior safety compared the femoral approach. It offers notable advantages in procedural efficiency, recovery, and cost-effectiveness, representing a feasible and recommendable alternative for clinical practice.