[1]包哲涵,张定虎,宋丹军,等.桡动脉穿刺失败后经肱动脉途径行肿瘤介入的临床观察[J].介入放射学杂志,2026,(06):651-655.[doi:10.3969/j.issn.1008-794X.2026.06.013 ]
 BAO Zhehan,ZHANG Dinghu,SONG Danjun,et al.Adopting transbrachial access after failure of radial artery puncturing in performing interventional treatment for tumors:evaluation of its clinical value[J].J Intervent Med,2026,(06):651-655.[doi:10.3969/j.issn.1008-794X.2026.06.013 ]
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桡动脉穿刺失败后经肱动脉途径行肿瘤介入的临床观察()

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

卷:
期数:
2026年06
页码:
651-655
栏目:
临床研究
出版日期:
2026-06-17

文章信息/Info

Title:
Adopting transbrachial access after failure of radial artery puncturing in performing interventional treatment for tumors:evaluation of its clinical value
文章编号:
1008-794X(2026)-006-0651-05
作者:
包哲涵 张定虎 宋丹军 徐 敏 郑家平 蒋梦君 郭立文
310022 浙江杭州 浙江省肿瘤医院介入治疗科,中国科学院杭州医学研究所,全省影像与介入医学重点实验室
Author(s):
BAO ZhehanZHANG DinghuSONG DanjunXU MinZHENG JiapingJIANG MengjunGUO Liwen.
Department of Interventional Radiology,Zhejiang Provincial Cancer Hospital,Hangzhou Institute of Medicine of Chinese Academy of Sciences,Zhejiang Provincial Key Laboratory of Imaging and Interventional Medicine,Hangzhou,Zhejiang Province 310022,China
关键词:
经桡动脉途径 经肱动脉途径 肝动脉灌注化疗 外周血管介入
分类号:
R730.59
DOI:
10.3969/j.issn.1008-794X.2026.06.013
文献标志码:
B
摘要:
目的 探讨经桡动脉途径(transradial access,TRA)穿刺置管失败后转为经肱动脉途径(transbrachial access,TBA)进行肿瘤介入治疗的安全性与可行性。方法 回顾性分析2024年7月至2025年6月期间于浙江省肿瘤医院接受TBA途径行肿瘤介入治疗患者的临床资料,重点统计并分析TBA途径的穿刺成功率及相关并发症情况。结果 观察期间共有67 例患者完成 122 人次行TBA途径肿瘤介入治疗,所有患者均因TRA穿刺失败而改为TBA途径,其中110人次接受经导管肝动脉灌注化疗术,12人次接受经导管肝动脉化疗栓塞术,患者的操作成功率达到100%; 85人次(69.7%,85/122)在后续的介入治疗中继续采用TBA入路,并成功完成穿刺置管。在安全性评估方面,共有7例(5.7%,7/122)出现轻微并发症,未见严重并发症发生。结论 TBA是肿瘤介入治疗安全可行的置管通路,可作为TRA失败后的代替通路。

参考文献/References:

[1] Llovet JM,Bruix J.Systematic review of randomized trials for unresectable hepatocellular carcinoma:Chemoembolization improves survival[J].Hepatology,2003,37:429-442.
[2]Lyu N,Wang X,Li JB,et al.Arterial chemotherapy of oxaliplatin plus fluorouracil versus sorafenib in advanced hepatocellular carcinoma:a biomolecular exploratory,randomized,phase Ⅲ trial(FOHAIC-1)[J].J Clin Oncol,2022,40:468-480.
[3]Chen SG,Wang XD,Yuan B,et al.Apatinib plus hepatic arterial infusion of oxaliplatin and raltitrexed for hepatocellular carcinoma with extrahepatic metastasis:phase Ⅱ trial[J].Nat Commun,2024,15:8857.
[4]Wang MC,Zhang J,Ji SF,et al.Transarterial chemoembolisation for breast cancer with liver metastasis:a systematic review[J].Breast,2017,36:25-30.
[5]Bo ST,Zhu J,He LX,et al.Transarterial chemoembolization for unresectable hepatocellular carcinoma:a comparative study between transradial and transfemoral approaches[J].Front Oncol,2025,15:1553939.
[6]Zhang XW,Luo YG,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.
[7]Junquera L,Urena M,Latib A,et al.Comparison of transfemoral versus transradial secondary access in transcatheter aortic valve replacement[J].Circ Cardiovasc Interv,2020,13:e008609.
[8]Schartz D,Akkipeddi SMK,Ellens N,et al.Complications of transradial versus transfemoral access for neuroendovascular procedures:a meta-analysis[J].J Neurointerv Surg,2022,14:820-825.
[9]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.e1.
[10]Sgueglia GA,Lee BK,Cho BR,et al.Distal radial access:consensus report of the first Korea-Europe transradial intervention meeting[J].JACC Cardiovasc Interv,2021,14:892-906.
[11]Schlosser J,Herrmann L,Böhme T,et al.Incidence and predictors of radial artery occlusion following transradial coronary angiography:the proRadial trial[J].Clin Res Cardiol,2023,112:1175-1185.
[12]Tsigkas G,Apostolos A,Davlouros P.Less is more,but not always:distal transradial access for radial artery occlusion prevention[J].JACC Cardiovasc Interv,2022,15:1202-1204.
[13]Lyu TY,Li M,He JA,et al.Analysis of the experience and procedural complications of trans-radial access versus trans-femoral access for hepatic arterial perfusion chemotherapy in patients with advanced hepatic malignancies:a retrospective study[J].Zhonghua Nei Ke Za Zhi,2024,63:183-191.
[14]Mantripragada K,Abadi K,Echeverry N,et al.Transbrachial access site complications in endovascular interventions:a systematic review of the literature[J].Cureus,2022,14:e25894.
[15]Qiu K,Liu XL,Jia ZY,et al.Comparing transbrachial and transradial as alternatives to transfemoral access for large-bore neuro stenting:insights from a propensity-matched study[J].Acad Radiol,2025,32:326-333.
[16]Lu CJ,Lin YH,Chu HJ,et al.Safety and efficacy of the transbrachial approach for endovascular thrombectomy in patients with acute large vessel occlusion stroke[J].J Formos Med Assoc,2021,120(1 Pt 3):705-712.
[17]van Dijk LJD,van Noord D,van Mierlo M,et al.Single-center retrospective comparative analysis of transradial,transbr-achial,and transfemoral approach for mesenteric arterial procedures[J].J Vasc Interv Radiol,2020,31:130-138.
[18]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.
Jiang HL,Meng XQ,Liao HQ,et al.Peripheral arterial intervention via transradial approach:evaluation of its safety and feasibility[J].J Interv Radiol,2018,27:1027-1030.
[19]Adnan SM,Romagnonli AN,Elansary NN,et al.Radial versus femoral arterial access for trauma endovascular interventions:a noninferiority study[J].J Trauma Acute Care Surg,2020,89:458-463.
[20]Soydan E,Akn M.Applicability of left distal radial artery access site in ST-segment elevation myocardial infarction; A comparative evaluation with the conventional transfemoral approach[J].J Vasc Access,2022,23:81-87.
[21]冷 岩,李兆南,朱海东.经桡动脉入路行外周血管动脉栓塞术的临床应用及研究现状[J].介入放射学杂志,2024,33:915-920.
Leng Y,Li ZN,Zhu HD.Clinical application and research status in the peripheral arterial embolization via transradial access[J].J Interv Radiol,2024,33:915-920.
[22]钱超一,郝伟远,邵国良,等.经桡动脉途径对肝癌患者行亚叶酸/5-氟尿嘧啶/奥沙利铂肝动脉持续灌注化疗的临床应用[J].介入放射学杂志,2023,32:474-477.
Qian CY,Hao WY,Shao GL,et al.Clinical application of hepatic arterial infusion chemotherapy via radial artery access by using FOLFOX scheme in treating patients with liver cancer[J].J Interv Radiol,2023,32:474-477.
[23]Khairnar SV,Nath RK,Yadav B,et al.Prevalence of abnormal upper limb arterial anatomy and its correlation with access failure during transradial coronary angiography[J].Indian Heart J,2021,73:44-48.
[24]Brunet MC,Chen SH,Peterson EC.Transradial access for neurointerventions:management of access challenges and complications[J].J Neurointerv Surg,2020,12:82-86.
[25]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.
[26]Naylor LH,Spence AL,Donker SCM,et al.Is there an athlete's artery? A comparison of brachial and femoral artery structure and function in male strength,power and endurance athletes[J].J Sci Med Sport,2021,24:635-640.
[27]Narsinh KH,Mirza MH,Duvvuri M,et al.Radial artery access anatomy:considerations for neuroendovascular procedures[J].J Neurointerv Surg,2021,13:1139-1144.
[28]Kaluski E,Shah A,Bianco M.Brachial artery access:easy way in……but cautious way out[J].Cardiovasc Revasc Med,2020,21:1274-1275.
[29]Lipchik EO,Sugimoto H.Percutaneous brachial artery catheterization[J].Radiology,1986,160:842-843.
[30]Smith DC,Mitchell DA,Peterson GW,et al.Medial brachial fascial compartment syndrome:anatomic basis of neuropathy after transaxillary arteriography[J].Radiology,1989,173:149-154.
[31]Steve LK,Sos TA.Brachial artery access[J].Tech Vasc Interv Radiol,2015,18:87-92.
[32]徐彦成,刘祎秀.肱动脉穿刺在经皮冠状动脉介入治疗术后并发症的预防及处理研究[J].中西医结合心血管病电子杂志,2018,6:82-83,86.
Xu YC,Liu YX.Prevention and treatment of complications after percutaneous coronary intervention with brachial artery puncture[J].Cardiovasc Dis J Integr Tradit Chin West Med,2018,6:82-83,86.
(收稿日期:2025-06-11)
(本文编辑:元 禾)

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备注/Memo

备注/Memo:
基金项目: 浙江省基础公益研究计划-自然科学基金探索项目(LTGY24H180014)
通信作者: 郭立文 E-mail:guolw@zjcc.org.cn
更新日期/Last Update: 2026-05-25