[1]中国抗癌协会肿瘤介入学专业委员会.经桡动脉入路外周介入中国专家共识[J].介入放射学杂志,2023,32(03):205-214.
 Chinese expert consensus on the transradial access in percutaneous peripheral interventions Chinese Society of Interventional Oncology, China Anti- Cancer Association[J].journal interventional radiology,2023,32(03):205-214.
点击复制

经桡动脉入路外周介入中国专家共识()

PDF下载中关闭

分享到:

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

卷:
32
期数:
2023年03
页码:
205-214
栏目:
指南与共识
出版日期:
2023-03-31

文章信息/Info

Title:
Chinese expert consensus on the transradial access in percutaneous peripheral interventions Chinese Society of Interventional Oncology, China Anti- Cancer Association
作者:
中国抗癌协会肿瘤介入学专业委员会
Author(s):
关键词:
【关键词】 经桡动脉入路经股动脉入路外周介入
文献标志码:
A
摘要:
【摘要】 经桡动脉入路(transradial access,TRA)行介入手术具有安全、舒适的特点,是冠脉介入的首选入路。但TRA在外周介入中应用不足。目前对如何选择合适的患者、合适的器械、降低TRA并发症及提高TRA使用率尚认识不足。为了更好地推广TRA在外周介入中的应用,指导TRA临床患者选择、技术操作规范和医师技能训练,中国抗癌协会肿瘤介入学专业委员会于2022年组织全国范围内的介入专家成立《经桡动脉入路外周介入中国专家共识》工作小组,并共同制定本共识。本文主要聚焦TRA外周应用现状、优势及局限性、桡动脉解剖学特征、患者选择、操作规范、常见并发症预防与处理、辐射剂量及学习曲线,并通过文献评价结合专家组意见达成共识。

参考文献/References:

[1] Seldinger SI. Catheter replacement of the needle in percutaneous arteriography. A new technique[J]. Acta radiol, 2008, 434:47-52.
[2] Campeau L. Percutaneous radial artery approach for coronary angiography[J]. Cathet Cardiovasc Diagn, 1989, 16: 3-7.
[3] Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines[J]. Circulation,2022,145:e4- e17.
[4] Valgimigli M, Frigoli E, Leonardi S, et al. Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome(MATRIX): final 1- year results of a multicentre, randomised controlled trial[J]. Lancet, 2018, 392: 835-848.
[5] Kolkailah AA, Alreshq RS, Muhammed AM, et al. Transradial versus transfemoral approach for diagnostic coronary angiography and percutaneous coronary intervention in people with coronary artery disease[J]. Cochrane Database Syst Rev, 2018, 4: CD012318.
[6] Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes(RIVAL): a randomised, parallel group, multicentre trial[J]. Lancet, 2011, 377: 1409-1420.
[7] Shoji S,Kohsaka S,Kumamaru H,et al. Cost reduction associated with transradial access in percutaneous coronary intervention: a report from a Japanese nationwide registry[J]. Lancet Reg Health West Pac, 2022, 28: 100555.
[8] 中华医学会心血管病学分会动脉粥样硬化和冠心病学组.急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志, 2019, 47:766-783.
[9] Iezzi R,Posa A,Bilhim T,et al. Most common misconceptions about transradial approach in interventional radiology: results from an international survey[J]. Diagn Interv Radiol, 2021, 27: 649- 653.
[10] Du N,Yang MJ,Ma JQ,et al. Transradial access chemoembolization for hepatocellular carcinoma in comparation with transfemoral access[J]. Transl Cancer Res, 2019, 8: 1795-1805.
[11] Du N,Ma JQ,Yang MJ,et al. Transradial access chemoembolization for hepatocellular carcinoma patients[J]. J Vis Exp, 2020, 163.
[12] Zhang X,Luo Y,Tsauo J,et al. Transradial versus transfemoral access without closure device for transarterial chemoembolization in patients with hepatocellular carcinoma: a randomized trial[J]. Eur Radiol, 2022, 32: 6812-6819.
[13] Jiang HL, Chen YN, Liao HQ, et al. Operator radiation dose during trans- hepatic arterial chemoembolization:different patients’ positions via transradial or transfemoral access[J]. Diagn Interv Radiol, 2022, 28: 376-382.
[14] Wu T, Sun R, Huang Y, et al. Partial splenic embolization of patients with hypersplenism by transradial or transfemoral approach: a prospective randomized controlled trial[J]. Acta Radiol, 2016, 57: 1201-1204.
[15] Wan Y,Chen B,Li N,et al. Transradial versus transfemoral access for patients with liver cancer undergoing hepatic arterial infusion chemotherapy: patient experience and procedural complications[J]. J Vasc Interv Radiol, 2022, 33: 956-963.
[16] 江海林,孟小茜,廖华强,等. 经桡动脉途径行外周介入的安全性与可行性[J]. 介入放射学杂志, 2018, 27:1027-1030.
[17] Fischman AM, Swinburne NC, Patel RS. A technical guide describing the use of transradial access technique for endovas- cular interventions[J]. Tech Vasc Interv Radiol, 2015, 18: 58- 65.
[18] Jaroenngarmsamer T, Bhatia KD, Kortman H, et al. Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis[J]. J Neurointerv Surg, 2020, 12: 87- 93.
[19] Snelling BM,Sur S,Shah SS,et al. Transradial approach for complex anterior and posterior circulation interventions: technical nuances and feasibility of using current devices[J]. Oper Neurosurg(Hagerstown), 2019, 17: 293-302.
[20] Burzotta F,Nerla R,Pirozzolo G,et al. Clinical and procedural impact of aortic arch anatomic variants in carotid stenting procedures[J]. Catheter Cardiovasc Interv, 2015, 86: 480- 489.
[21] Brueck M,Bandorski D,Kramer W,et al. A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty[J]. JACC Cardiovasc Interv, 2009, 2: 1047-1054.
[22] Bhat FA,Changal KH,Raina H,et al. Transradial versus trans-femoral approach for coronary angiography and angioplasty:a prospective,randomized comparison[J]. BMC Cardiovasc Disord, 2017, 17: 23.
[23] Malloy PC, Grassi CJ, Kundu S, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image- guided interventions[J]. J Vasc Interv Radiol, 2009, 20: S240-S249.
[24] Titano JJ, Biederman DM, Zech J, et al. Safety and outcomes of transradial access in patients with international normalized ratio 1.5 or above[J]. J Vasc Interv Radiol , 2018, 29: 383-388.
[25] 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.
[26] Ruzsa Z,Csavajda A,Hizoh I,et al. TRIACCESS study: randomized comparison between radial, femoral, and pedal access for percutaneous femoro-popliteal artery angioplasty[J]. J Endovasc Ther, 2022, 29: 215-225.
[27] Piccolo R, Galasso G, Capuano E, et al. Transradial versus transfemoral approach in patients undergoing percutaneous coronary intervention for acute coronary syndrome. A meta-analysis and trial sequential analysis of randomized controlled trials[J]. PLoS One, 2014, 9: e96127.
[28] Jin C, Li W, Qiao SB, et al. Costs and benefits associated with transradial versus transfemoral percutaneous coronary inter-vention in China[J]. J Am Heart Assoc, 2016, 5: e002684.
[29] Valgimigli M, Gagnor A, Calabro P, et al. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial[J]. Lancet, 2015, 385: 2465-2476.
[30] Liu LB, Cedillo MA, Bishay V, et al. Patient experience and preference in transradial versus transfemoral access during transarterial radioembolization: a randomized single-center trial[J]. J Vasc Interv Radiol, 2019, 30: 414- 420.
[31] Iezzi R, Pompili M, Posa A, et al. Transradial versus transfemoral access for hepatic chemoembolization: intrapatient prospective single-center study[J]. J Vasc Interv Radiol, 2017, 28: 1234-1239.
[32] Yamada R, racewell S,Bassaco B,et al. Transradial versus trans-femoral arterial access in liver cancer embolization: randomized trial to assess patient satisfaction[J]. J Vasc Interv Radiol, 2018, 29: 38- 43.
[33] Cooper CJ,El-Shiekh RA,Cohen DJ, et al. Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison[J]. Am Heart J, 1999, 138: 430- 436.
[34] Brunet MC, Chen SH, Peterson EC. Transradial access for neuro-interventions: management of access challenges and complications[J]. J Neurointerv Surg, 2020, 12: 82-86.
[35] Lo TS, Nolan J, Fountzopoulos E, et al. Radial artery anomaly and its influence on transradial coronary procedural outcome[J]. Heart, 2009, 95: 410- 415.
[36] Zarzecki MP,Popieluszko P,Zayachkowski A, et al. The surgical anatomy of the superficial and deep palmar arches: a meta-analysis[J]. J Plast Reconstr Aesthet Surg, 2018, 71: 1577-1592.
[37] 杨志明,柴婵娟,朱国斌,等. 成人右侧尺、桡动脉彩色多普勒超声测量的对比研究[J]. 中国介入心脏病学杂志, 2010, 18:277-279.
[38] Allen EV. Thromboangiitis obliterans: methods of diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases[J]. Am J Med Sci, 1929, 178: 237-243.
[39] Barbeau GR,Arsenault F,Dugas L,et al. Evaluation of the ulnopalmar arterial arches with pulse oximetry and plethysmography: comparison with the Allen’s test in 1010 patients[J]. Am Heart J, 2004, 147: 489-493.
[40] Vallespin J, Meola M, Ibeas J. Upper limb anatomy and pre-operative mapping[J]. J Vasc Access, 2021, 22: 9-17.
[41] Basile A,Rebonato A,Failla G,et al. Early post- procedural patients compliance and VAS after UAE through transradial versus transfemoral approach: preliminary results[J]. Radiol Med, 2018, 123: 885-889.
[42] Nguyen P,Makris A,Hennessy A,et al. Standard versus ultrasound- guided radial and femoral access in coronary angiography and intervention(SURF): a randomised controlled trial[J]. Euro-Intervention, 2019, 15: e522- e530.
[43] Flumignan RL,Trevisani VF,Lopes RD,et al. Ultrasound guidance for arterial(other than femoral) catheterisation in adults[J]. Cochrane Database Syst Rev, 2021, 10: CD013585.
[44] Seto AH, Roberts JS, Abu-Fadel MS, et al. Real-time ultrasound guidance facilitates transradial access: RAUST(Radial Artery access with Ultrasound Trial)[J]. JACC Cardiovasc Interv, 2015, 8: 283-291.
[45] Sandoval Y, Bell MR, Gulati R. Transradial artery access complications[J]. Circ Cardiovasc Interv, 2019, 12: e007386.
[46] Saito S, Ikei H, Hosokawa G, et al. Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention[J]. Catheter Cardiovasc Interv, 1999, 46: 173-178.
[47] Bernat I, Aminian A, Pancholy S, et al. Best practices for the prevention of radial artery occlusion after transradial diagnostic angiography and intervention: an international consensus paper[J]. JACC Cardiovasc Interv, 2019, 12: 2235-2246.
[48] Wang Y, Tang J, Ni J, et al. A comparative study of TR Band and a new hemostatic compression device after transradial coronary catheterization[J]. J Interv Med, 2019, 1: 221-228.
[49] Corcos T. Distal radial access for coronary angiography and percutaneous coronary intervention: a state- of- the- art review[J]. Catheter Cardiovasc Interv, 2019, 93: 639- 644.
[50] Aminian A,Sgueglia GA,Wiemer M,et al. Distal versus conven- tional radial access for coronary angiography and intervention: the DISCO RADIAL trial[J]. JACC Cardiovasc Interv, 2022, 15: 1191-1201.
[51] Karrowni W,Vyas A,Giacomino B,et al. Radial versus femoral access for primary percutaneous interventions in ST- segment elevation myocardial infarction patients: a meta- analysis of randomized controlled trials[J]. JACC Cardiovasc Interv, 2013, 6: 814-823.
[52] Mehta SR,Jolly SS,Cairns J,et al. Effects of radial versus femoral artery access in patients with acute coronary syndromes with or without ST- segment elevation[J]. J Am Coll Cardiol, 2012, 60: 2490-2499.
[53] Romagnoli E,Biondi-Zoccai G,Sciahbasi A,et al. Radial versus femoral randomized investigation in ST- segment elevation acute coronary syndrome: the RIFLE-STEACS(Radial Versus Femoral Randomized Investigation in ST- Elevation Acute Coronary Syndrome) study[J]. J Am Coll Cardiol, 2012, 60: 2481-2489.
[54] Posham R,Biederman DM,Patel RS,et al. Transradial approach for noncoronary interventions: a single- center review of safety and feasibility in the first 1,500 cases[J]. J Vasc Interv Radiol, 2016, 27: 159-166.
[55] Thakor AS,Alshammari MT,Liu DM,et al. Transradial access for interventional radiology: single- centre procedural and clinical outcome analysis[J]. Can Assoc Radiol J, 2017, 68: 318-327.
[56] Bishay VL,Biederman DM,Ward TJ,et al. Transradial approach for hepatic radioembolization: initial results and technique[J]. AJR Am J Roentgenol, 2016, 207: 1112-1121.
[57] Hung ML,Lee EW,McWilliams JP,et al. A reality check in transradial access: a single- centre comparison of transradial and transfemoral access for abdominal and peripheral intervention[J]. Eur Radiol, 2019, 29: 68-74.
[58] Aminian A,Dolatabadi D,Lefebvre P,et al. Initial experience with the Glidesheath Slender for transradial coronary angiography and intervention: a feasibility study with prospective radial ultrasound follow- up[J]. Catheter Cardiovasc Interv, 2014, 84: 436- 442.
[59] Liang D, Lin Q, Zhu Q, et al. Short- term postoperative use of rivaroxaban to prevent radial artery occlusion after transradial coronary procedure: the RESTORE randomized trial[J]. Circ Cardiovasc Interv, 2022, 15: e011555.
[60] Pancholy S, Coppola J, Patel T, et al. Prevention of radial artery occlusion- patent hemostasis evaluation trial(PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization[J]. Catheter Cardiovasc Interv, 2008, 72: 335-340.
[61] Pancholy SB,Heck LA,Patel T. Forearm arterial anatomy and flow characteristics: a prospective observational study[J]. J Invasive Cardiol, 2015, 27: 218-221.
[62] Edris A, Gordin J, Sallam T, et al. Facilitated patent haemostasis after transradial catheterisation to reduce radial artery occlusion[J]. EuroIntervention, 2015, 11: 765-771.
[63] Dangoisse V, Guédès A, Chenu P, et al. Usefulness of a gentle and short hemostasis using the transradial band device after transradial access for percutaneous coronary angiography and interventions to reduce the radial artery occlusion rate(from the prospective and randomized CRASOC Ⅰ,Ⅱ, and Ⅲ studies)[J]. Am J Cardiol, 2017, 120: 374-379.
[64] Zankl AR, Andrassy M, Volz C, et al. Radial artery thrombosis following transradial coronary angiography: incidence and rationale for treatment of symptomatic patients with low- molecular- weight heparins[J]. Clin Res Cardiol, 2010, 99: 841- 847.
[65] Bernat I, Bertrand OF, Rokyta R, et al. Efficacy and safety of transient ulnar artery compression to recanalize acute radial artery occlusion after transradial catheterization[J]. Am J Cardiol, 2011, 107: 1698-1701.
[66] Pancholy S. Recanalization and reuse of early occluded radial artery within 6 days after previous transradial diagnostic procedure[J]. Catheter Cardiovasc Interv, 2012, 79: 348.
[67] Pancholy SB. Transradial access in an occluded radial artery: new technique[J]. J Invasive Cardiol, 2007, 19: 541-544.
[68] Gayed A,Yamada R,Bhatia S,et al. Society of interventional radiology quality improvement standards on radial artery access[J]. J Vasc Interv Radiol , 2021, 32: 761.e1-761.e21.
[69] Tizon- Marcos H, Barbeau GR. Incidence of compartment syndrome of the arm in a large series of transradial approach for coronary procedures[J]. J Interv Cardiol, 2008, 21: 380-384.
[70] Hadad MJ,Puvanesarajah V,Deune EG.Complications of transradial catheterization and cannulation[J]. J Hand Surg Am, 2019, 44: 973-979.
[71] Zegri I,Garcia-Touchard A,Cuenca S,et al. Radial artery pseudo-aneurysm following cardiac catheterization: clinical features and nonsurgical treatment results[J]. Rev Esp Cardiol (Engl Ed), 2015, 68: 349-351.
[72] Garvin RP,Ryer EJ,Yoon HR,et al. Ultrasound- guided percuta-neous thrombin injection of iatrogenic upper extremity pseudoa-neurysms[J]. J Vasc Surg, 2014, 59: 1664-1669.
[73] Agostoni P, Biondi-Zoccai GG, de Benedictis ML, et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials[J]. J Am Coll Cardiol, 2004, 44: 349-356.
[74] Jolly SS, Cairns J,Niemela K,et al. Effect of radial versus femoral access on radiation dose and the importance of procedural volume: a substudy of the multicenter randomized RIVAL trial[J]. JACC Cardiovasc Interv, 2013, 6: 258-266.
[75] Chen YY, Liu P, Wu YS, et al. Transradial vs transfemoral access in patients with hepatic malignancy and undergoing hepatic interventions: a systematic review and meta-analysis[J]. Medicine(Baltimore), 2018, 97: e13926.
[76] van Malenstein H,Maleux G,Vandecaveye V,et al. A randomized phase Ⅱ study of drug- eluting beads versus transarterial chemo-embolization for unresectable hepatocellular carcinoma[J]. Onko-logie, 2011, 34: 368-376.
[77] 江海林,孟小茜,廖华强,等.不同体位经桡动脉途径行TACE术的透视时间对比[J]. 介入放射学杂志, 2021, 30:275-278.
[78] Shah RM, Patel D, Abbate A, et al. Comparison of transradial coronary procedures via right radial versus left radial artery approach: a meta- analysis[J]. Catheter Cardiovasc Interv, 2016, 88: 1027-1033.
[79] Mortensen C, Chung J, Liu D, et al. Prospective study on total fluoroscopic time in patients undergoing uterine artery embolization: comparing transradial and transfemoral approaches[J]. Cardiovasc Intervent Radiol, 2019, 42: 441-447.
[80] Ball WT,Sharieff W,Jolly SS,et al. Characterization of operator learning curve for transradial coronary interventions[J]. Circ Cardiovasc Interv, 2011, 4: 336-341.
[81] Jayanti S, Juergens C, Makris A, et al. The learning curves for transradial and ultrasound- guided arterial access: an analysis of the SURF trial[J]. Heart Lung Circ, 2021, 30: 1329-1336.
[82] Liu Y,Wen X,Bai J,et al. A single- center,randomized, controlled comparison of the transradial vs transfemoral approach for cerebral angiography: a learning curve analysis[J]. J Endovasc Ther, 2019, 26: 717-724.
[83] Iezzi R,Posa A,Merlino B,et al. Operator learning curve for transradial liver cancer embolization: implications for the initiation of a transradial access program[J]. Diagn Interv Radiol, 2019, 25: 368-374.
[84] Sciahbasi A,Romagnoli E,Trani C,et al. Evaluation of the “learning curve” for left and right radial approach during percutaneous coronary procedures[J]. Am J Cardiol, 2011, 108: 185-188.
[85] Oh EJ, Lee JH, Kwon EJ, et al. Simulation- based training using a vessel phantom effectively improved first attempt success and dynamic needle- tip positioning ability for ultrasound- guided radial artery cannulation in real patients: an assessor- blinded randomized controlled study[J]. PLoS One, 2020, 15: e0234567.

备注/Memo

备注/Memo:
(收稿日期:2022-12-07)
(本文编辑:茹 实)
更新日期/Last Update: 2023-03-28