[1]吴剑,蔡然泽,李秋平,等.左侧远端桡动脉/桡动脉入路在神经介入诊疗中的临床应用 [J].介入放射学杂志,2024,33(12):1288-1292.
WU Jian,CAI Ranze,LI Qiuping,et al.Clinical application of left distal transradial artery/transradial artery access in neurointerventional diagnosis and treatment[J].journal interventional radiology,2024,33(12):1288-1292.
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左侧远端桡动脉/桡动脉入路在神经介入诊疗中的临床应用
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
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33
- 期数:
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2024年12
- 页码:
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1288-1292
- 栏目:
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神经介入
- 出版日期:
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2024-12-25
文章信息/Info
- Title:
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Clinical application of left distal transradial artery/transradial artery access in neurointerventional diagnosis and treatment
- 作者:
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吴剑; 蔡然泽; 李秋平; 齐飚
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- Author(s):
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WU Jian; CAI Ranze; LI Qiuping; QI Biao.
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Department of Neurosurgery,Xiamen Branch,Affiliated Zhongshan Hospital of Fudan University,Xiamen,Fujian Province 361000,China
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- 关键词:
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【关键词】左侧桡动脉入路; 左侧远端桡动脉入路; 神经介入治疗; 脑血管造影
- 文献标志码:
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A
- 摘要:
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【摘要】目的观察左侧远端桡动脉(dTRA)/桡动脉(TRA)入路神经介入诊疗的安全性及可行性。方法回顾性分析复旦大学附属中山医院厦门医院2022年1月至2023年12月收治的接受右侧、左侧dTRA/TRA行脑血管造影及神经介入诊疗患者的资料,包括一般信息(年龄、性别、基础疾病等)、临床资料(手术方式、手术入路、X线透视时间、穿刺相关并发症等)。 结果纳入经左侧dTRA/TRA行神经介入诊疗患者32例,其中造影11例,介入治疗21例,介入治疗患者均为左侧椎基底动脉疾病。纳入同期经右侧dTRA/TRA行神经介入诊疗患者49例,其中造影19例,血管内治疗30例,介入治疗患者均为右侧椎基底动脉疾病,造影患者均为既往接受治疗后复查造影,且均为前循环系统血管内疾病。所有行介入治疗及造影患者均顺利完成手术且无严重并发症。经左侧dTRA/TRA行介入治疗患者中,4例改TRA完成手术,2例改股动脉(TFA),1例经左侧dTRA因血管通路不稳定改TFA继续完成手术;行造影患者中4例患者改左侧TRA顺利完成造影,共3例患者未能完成选择性右侧锁骨下动脉插管;行介入治疗的患者中有2例术后出现远端桡动脉穿刺点局部淤青,所有造影及介入治疗患者术后复查彩超均未见桡动脉闭塞。经右侧dTRA/TRA行神经介入患者中,4例改右侧TRA完成手术,2例改TFA;行造影患者中4例改右侧TRA,所有患者均顺利完成双侧颈总动脉,双侧锁骨下动脉血管插管,有3例术后出现远端桡动脉穿刺点局部淤青,所有造影及介入治疗患者术后复查彩超均未见桡动脉闭塞。在神经介入诊疗中,经左侧dTRA/TRA和右侧dTRA/TRA对比,穿刺远端桡动脉成功率、术中X线透视时间、对4根主要血管(右侧颈总动脉、左侧颈总动脉、右侧锁骨下动脉、左侧锁骨下动脉)的插管成功率、术后穿刺点并发症的发生率差异均无统计学意义(均P<0.05)。结论左侧远端桡动脉/桡动脉入路行脑血管造影及神经介入治疗是安全可行的。
参考文献/References:
[1]Satti SR,Vance AZ,Golwala SN,et al.Patient preference for transradial access over transfemoral access for cerebrovascular procedures[J].J Vasc Interv Neurol,2017,9:1-5.
[2]Kühn AL,de Macedo RK,Singh J,et al.Distal radial access in the anatomical snuffbox for neurointerventions:a feasibility,safety,and proof-of-concept study[J].J Neurointerv Surg,2020,12:798-801.
[3]Rodriguez CI,Barranco-Pons R,Klass D,et al.Distal transradial artery access for neuroangiography and neurointerventions:pitfalls and exploring the boundaries[J].Clin Neuroradiol,2022,32:427-434.
[4]何晓芬,郭旭范,范承哲,等.神经介入患者远端桡动脉入路诊疗安全性和可行性[J].介入放射学杂志,2022,31:954-957.
[5]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.
[6]Larsen P,Shah S,Waxman S,et al.Comparison of procedural times,success rates,and safety between left versus right radial arterial access in primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction[J].Catheter Cardiovasc Interv,2011,78:38-44.
[7]Ito H,Uchida M,Takasuna H,et al.Left transradial neurointerventions using the 6-french simmons guiding sheath:initial experiences with the interchange technique[J].World Neurosurg,2021,152:e344-e351.
[8]Chalouhi N,Sweid A,Al Saiegh F,et al.Feasibility and initial experience of left radial approach for diagnostic neuroangiography[J].Sci Rep,2021,11:1089.
[9]Chalouhi N,Sweid A,Al Saiegh F,et al.Initial experience with transradial intraoperative angiography in aneurysm clipping:technique,feasibility,and case series[J].World Neurosurg,2020,134:e554-e558.
[10]Yoshimachi F,Ikari Y.Distal radial approach:a review on achieving a high success rate[J].Cardiovasc Interv Ther,2021,36:30-38.
[11]Meo D,Falsaperla D,Modica A,et al.Proximal and distal radial artery approaches for endovascular percutaneous procedures:anatomical suitability by ultrasound evaluation[J].Radiol Med,2021,126:630-635.
[12]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.
[13]Tangwiwat S,Pankla W,Rushatamukayanunt P,et al.Comparing the success rate of radial artery cannulation under ultrasound guidance and palpation technique in adults[J].J Med Assoc Thai,2016,99:505-510.
[14]Uchida M,Ito H,Takasuna H,et al.Initial Experience with left transradial neurointerventions for cerebral aneurysms using the 6-french simmons guiding sheath[J].J Stroke Cerebrovasc Dis,2022,31:106350.
[15]Barros G,Bass DI,Osbun JW,et al.Left transradial access for cerebral angiography[J].J Neurointerv Surg,2020,12:427-430.
[16]Crockett MT,Selkirk GD,Chiu AH,et al.Arterial access site complications in transradial neurointerventions:single center review of 750 consecutive cases.Clin Neuroradiol,2020,30:639-642.
[17]Brunet MC,Chen SH,Peterson EC.Transradial access for neurointerventions:management of access challenges and complications[J].J Neurointerv Surg,2020,12:82-86.
[18]Xie L,Wei X,Xie Z,et al.Feasibility of distal radial access for coronary angiography and percutaneous coronary intervention:a single center experience[J].Cardiology,2021,146:531-537.
[19]Umekawa M,Koizumi S,Ohara K,et al.Distal radial artery approach is safe and effective for cerebral angiography and neuroendovascular treatment:a single-center experience with ultrasonographic measurement[J].Interv Neuroradiol,2022:15910199221135308.
[20]Patel P,Majmundar N,Bach I,et al.Distal transradial access in the anatomic snuffbox for diagnostic cerebral angiography[J].AJNR Am J Neuroradiol,2019,40:1526-1528.
[21]Chivot C,Bouzerar R,Yzet T.A novel technique to perform cerebral angiography via the left radial approach:an 80 patients series[J].J Neuroradiol,2023,50:93-98.
备注/Memo
- 备注/Memo:
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(收稿日期:2024-01-08)
(本文编辑:新宇)
更新日期/Last Update:
2024-12-18