[1]戴孝森,李 静,杨 攀,等.经不同入路行脑血管造影安全性和有效性的Meta分析[J].介入放射学杂志,2026,(09):968-976.[doi:10.3969/j.issn.1008-794X.2026.09.002]
　DAI Xiaosen,LI Jing,YANG Pan,et al.The safety and efficacy of cerebral angiography via different approaches:a meta-analysis[J].J Intervent Med,2026,(09):968-976.[doi:10.3969/j.issn.1008-794X.2026.09.002]
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经不同入路行脑血管造影安全性和有效性的Meta分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年09
页码:
968-976
栏目:
神经介入
出版日期:
2026-09-10

文章信息/Info

Title:
The safety and efficacy of cerebral angiography via different approaches:a meta-analysis
文章编号:
1008-794X(2026)-009-0968-09
作者:
戴孝森;  李 静;  杨 攀;  侯德文
629000 四川遂宁 遂宁市中医院脑病科(戴孝森、杨 攀、侯德文); 遂宁市中医院病案统计室(李 静)
Author(s):
DAI Xiaosen; LI Jing; YANG Pan; HOU Dewen.
Department of Encephalopathy,Suining Municipal Hospital of Traditional Chinese Medicine,Suining,Sichuan Province 629000,China
关键词:
桡动脉入路;  股动脉入路;  脑血管造影;  Meta分析
分类号:
R743
DOI:
10.3969/j.issn.1008-794X.2026.09.002
文献标志码:
A
摘要:
目的 比较经桡动脉入路和股动脉入路行脑血管造影的效果差异,为临床选择更优的造影入路提供循证依据。方法 计算机检索PubMed、Embase、The Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普数据库和万方数据库,搜集有关经桡动脉入路和股动脉入路行脑血管造影的随机对照试验(randomized controlled trial,RCT),检索时限均为建库至2025年10月。由两名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果 共纳入16个RCT,包括5 467例患者。Meta分析结果显示,两种入路造影成功率效果相当,但桡动脉入路曝光时间和手术时间较短,且桡动脉入路穿刺点血肿发生率为0.17(95%CI:0.11～0.25),异质性较低(I2=10%); 假性动脉瘤发生率为0.16(95%CI:0.07～0.32),无异质性(I2=0); 动静脉瘘发生率为0.33(95%CI:0.11～0.97),无异质性(I2=0)。结论 当前证据表明,经桡动脉入路并发症发生率较低,且患者舒适度更高,是安全、可行的。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

参考文献/References:

[1] 刘丽萍,周宏宇,段婉莹,等.中国脑血管病临床管理指南(第2版)(节选):第4章缺血性脑血管病临床管理推荐意见[J].中国卒中杂志,2023,18:910-933.
Liu LP,Zhou HY,Duan WY,et al.Chinese stroke association guidelines for clinical management of cerebrovascular diseases(second edition)(excerpt):chapter four clinical management of ischaemic cerebrovascular diseases[J].Chin J Stroke,2023,18:910-933.
[2]《中国脑卒中防治报告》编写组.《中国脑卒中防治报告2021》概要[J].中国脑血管病杂志,2023,20:783-792.
Editorial Group of Brief Report on Stroke Prevention and Treatment in China.Brief report on stroke prevention and treatment in China,2021[J].Chin J Cerebrovasc Dis,2023,20:783-792.
[3]王 健,曹 刚,郑 寅,等.经远端桡动脉路径行脑血管造影的安全性和有效性:系统评价和Meta分析[J].介入放射学杂志,2024,33:355-362.
Wang J,Cao G,Zheng Y,et al.The safety and effectiveness of cerebral angiography via distal radial access:systematic evaluation and meta-analysis[J].J Interv Radiol,2024,33:355-362.
[4]Aksoy MN,Sahinkus S,Agac MT,et al.A randomized trial comparing left distal radial versus femoral approach for coronary artery bypass graft angiography:a pilot study[J].Minerva Cardiol Angiol,2023,71:27-34.
[5]Phillips TJ,Crockett MT,Selkirk GD,et al.Transradial versus transfemoral access for anterior circulation mechanical thrombectomy:analysis of 375 consecutive cases[J].Stroke Vasc Neurol,2021,6:207-213.
[6]Ge BH,Wei YH.Comparison of transfemoral cerebral angiography and transradial cerebral angiography following a shift in practice during four years at a single center in China[J].Med Sci Monit,2020,26:e921631.
[7]Xi H,Lu CY,Wang N,et al.Effects of different puncture approaches on the curative effect and safety of patients with combined cardiovascular and cerebrovascular angiography[J].Videosurgery Other Miniinvasive Tech,2024,19:107-112.
[8]Wang ZL,Xia JC,Wang W,et al.Transradial versus transfemoral approach for cerebral angiography:a prospective comparison[J].J Interv Med,2019,2:31-34.
[9]刘 欣,董丹凤,吉 智,等.经桡动脉脑血管造影及术后血管封堵术对患者疗效及安全性观察[J].现代生物医学进展,2021,21:1116-1119.
Liu X,Dong DF,Ji Z,et al.Efficacy and safety of transradial angiography and occlusion[J].Prog Mod Biomed,2021,21:1116-1119.
[10]刘淑英.经桡动脉与经股动脉入路对全脑血管造影的应用效果对比[J].康颐,2025:169-171.
Liu SY.Comparison of application efficacy between transradial and transfemoral approaches in cerebral angiography[J].Kang Yi,2025:169-171.
[11]刘高飞,朱 敏,秦锦标,等.经桡动脉全脑血管造影术在青年缺血性脑血管病诊断中的应用[J].中国脑血管病杂志,2015,12:189-191.
Liu GF,Zhu M,Qin JB,et al.Application of whole brain angiography via radial approach in young patients for the diagnosis of ischemic cerebrovascular disease[J].Chin J Cerebrovasc Dis,2015,12:189-191.
[12]周逸帆,何泰吉,魏艳花,等.经桡动脉脑血管造影术的应用价值研究[J].中国实用医药,2024,19:46-49.
Zhou YF,He TJ,Wei YH,et al.Study on application value of transradial cerebral angiography[J].China Pract Med,2024,19:46-49.
[13]潘立艳,卢向丽,代慈祥,等.经不同血管径路在行全脑血管造影术中的临床价值比较:一项单中心随机对照研究[J].糖尿病之友,2023:82-83.
Pan LY,Lu XL,Dai CX,et al.Comparison of clinical value via different vascular approaches in cerebral angiography:a single-center randomized controlled trial[J].Tangniaobing Zhiyou,2023:82-83.
[14]王斌全,刘 勇.经桡动脉和股动脉途径的全脑血管造影在临床应用价值研究[J].医药卫生,2023:91-93.
Wang BQ,Liu Y.Clinical application value of cerebral angiography via transradial and femoral approaches[J].J Med Health,2023:91-93.
[15]王 超,陈健龙,蔡仁端,等.经右桡动脉与股动脉入路行全脑血管造影患者辐射剂量的对比研究[J].医药卫生,2024:56-59.
Wang C,Chen JL,Cai RD,et al.Comparison of radiation dose in patients undergoing cerebral angiography via right transradial versus transfemoral approach:a comparative study[J].J Med Health,2024:56-59.
[16]王 鸿.对比经桡动脉穿刺与经股动脉穿刺对脑血管造影结果的影响及并发症发生的临床分析[J].医学食疗与健康,2023,21:43-45,52.
Wang H.Clinical analysis of the impact on cerebral angiography outcomes and complications:a comparison between transradial and transfemoral puncture[J].Med Diet and Health,2023,21:43-45,52.
[17]石郁喜.探析经桡动脉途径在全脑血管造影中的优点及方式[J].智慧健康,2022,8:165-169.
Shi YX.Exploring the advantages and methods of transradial approach in whole cerebral angiography[J].Smart Healthc,2022,8:165-169.
[18]胡凌云,田 杰,胡建川,等.老年患者经桡动脉径路与股动脉径路行选择性冠状动脉和脑动脉联合造影的对比研究[J].中华老年心脑血管病杂志,2021,23:200-202.
Hu LY,Tian J,Hu JC,et al.Comparative study of selective coronary angiography and cerebral angiography by radial artery approach and femoral artery approach in elderly patients[J].Chin J Geriatr Heart Brain Vessel Dis,2021,23:200-202.
[19]艾克拜尔·加马力,关玉华.经桡动脉与经股动脉途径全脑血管造影的对比分析[J].临床医药文献电子杂志,2018,5:64-69.
Aikebaier·Jiamal,Guan YH.The efficacy and safety of transradial and transfemoral whole-brain angiography to diagnose cerebrovascular disease:a meta-analysis[J].J Clin Med Lit,2018,5:64-69.
[20]赵四海.经远端桡动脉穿刺行脑血管造影的临床应用[J].医药卫生,2023:52-54.
Zhao SH.Clinical application of cerebral angiography via distal transradial artery puncture[J].J Med Health,2023:52-54.
[21]邱敬锦,梁 艳,凌世光.经桡动脉途径与经股动脉途径全脑血管造影术应用效果的对比分析[J].世界复合医学,2021,7:63-65,78.
Qiu JJ,Liang Y,Ling SG.Comparative analysis of the effect of whole cerebral angiography through the Radial artery and the femoral artery[J].World J Complex Med,2021,7:63-65,78.
[22]蔡然泽,吴 剑,齐 飚.神经介入治疗中桡动脉闭塞重复再通安全性和可行性分析[J].介入放射学杂志,2024,33:1053-1056.
Cai RZ,Wu J,Qi B.Repeated recanalization of radial artery occlusion in neurointerventional therapy:analysis of its safety and feasibility[J].J Interv Radiol,2024,33:1053-1056.
[23]Hoh BL,Ko NU,Amin-Hanjani S,et al.2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage:a guideline from the American heart association/American stroke association[J].Stroke,2023,54:e314-e370.
[24]Yang MJ,Jiang S,Wang YL,et al.Chinese expert consensus on transradial access in percutaneous peripheral interventions[J].J Interv Med,2023,6:145-152.
[25]中华医学会神经病学分会,中华医学会神经病学分会神经血管介入协作组.脑血管造影术操作规范中国专家共识[J].中华神经科杂志,2018,51:7-13.
Chinese Society of Neurology,Chinese Society of Neurovascular Interventional Group.China expert consensus on the operation specification of cerebral angiography[J].Chin J Neurol,2018,51:7-13.
[26]Catapano JS,Fredrickson VL,Fujii T,et al.Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment[J].J Neurointerv Surg,2020,12:611-615.
[27]Ghaith AK,El Naamani K,Mualem W,et al.Transradial versus transfemoral approaches in diagnostic and therapeutic neuroendovascular interventions:a meta-analysis of current literature[J].World Neurosurg,2022,164:e694-e705.
[28]Zarzecki MP,Popieluszko P,Zayachkowski A,et al.The surgical anatomy of the superficial and deep palmar Arches:a Meta-analysis[J].J PlastReconstr Aesthet Surg,2018,71:1577-1592.
[29]潘文龙,王 芳,罗永春.经桡动脉路径行神经介入治疗患者的围术期护理研究进展[J].介入放射学杂志,2024,33:1142-1146.
Pan WL,Wang F,Luo YC.Research progress in perioperative nursing for patients undergoing neurointerventional therapy via radial artery access[J].J Interv Radiol,2024,33:1142-1146.
[30]Bhatia K,Guest W,Lee H,et al.Radial vs.femoral artery access for procedural success in diagnostic cerebral angiography:a randomized clinical trial[J].Clin Neuroradiol,2021,31:1083-1091.
[31]Son C,Tavakoli S,Mahadev V.Systematic review of transradial access for flow diversion of intracranial aneurysms[J].World Neurosurg,2021,151:6-11.
[32]Sweid A,Das S,Weinberg JH,et al.Transradial approach for diagnostic cerebral angiograms in the elderly:a comparative observational study[J].J Neurointerv Surg,2020,12:1235-1241.
[33]Osbun JW,Patel B,Levitt MR,et al.Transradial intraoperative cerebral angiography:a multicenter case series and technical report[J].J Neurointerv Surg,2020,12:170-175.
(收稿日期:2025-12-25)
(本文编辑:元 禾)

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备注/Memo

备注/Memo:
基金项目: 国家卫生健康委医药卫生科技发展研究中心资助项目(WKZX2025CZ0403)
通信作者: 戴孝森 E-mail:275251872@qq.com
更新日期/Last Update: 2026-09-25