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经桡动脉途径选择性脑血管造影的实用性

[Usefulness of selective cerebral angiography by transradial approach].

作者信息

Nagayoshi K, Ikeda M, Hirai N, Kimura S, Kiya K, Uetani M

机构信息

Department of Radiology, Hiroshima Prefectural Hiroshima Hospital.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 2000 Jan;60(1):28-32.

Abstract

Transradial angiography has recently emerged as an alternative to the transfemoral or transbrachial approach, especially for coronary procedures. However, there have been few studies on cerebral angiography using the transradial approach. The purpose of this study was to assess the outcomes, complications, and limitations of selective cerebral angiography via the transradial approach. Selective cerebral angiography by the right transradial approach using 100-cm-long 4-F catheters was performed in 83 patients. Using five types of catheters, the success rates of selective catheterization to the right vertebral artery, right common carotid artery, left common carotid artery, and left vertebral artery were 40/44 (91%), 68/68 (100%), 62/62 (100%), and 14/25 (56%), respectively. Puncture failed in one patient, and a guidewire could not be introduced beyond the radial artery loop in one patient. Radial artery spasm occurred in one patient, but was relieved immediately after nitroglycerin injection through the sheath with side holes. Subcutaneous bleeding occurred in six patients, but no obvious hematomas were noted. Occlusion or stenosis of the radial artery occurred in five patients, but no ischemic symptoms were observed in any of the cases. This study suggested that selective cerebral angiography can be performed safely using the transradial approach.

摘要

经桡动脉血管造影术最近已成为经股动脉或经肱动脉途径的替代方法,尤其是在冠状动脉手术中。然而,关于经桡动脉途径进行脑血管造影的研究很少。本研究的目的是评估经桡动脉途径进行选择性脑血管造影的结果、并发症和局限性。对83例患者采用100厘米长的4F导管经右桡动脉途径进行选择性脑血管造影。使用五种类型的导管,选择性导管插入右椎动脉、右颈总动脉、左颈总动脉和左椎动脉的成功率分别为40/44(91%)、68/68(100%)、62/62(100%)和14/25(56%)。1例患者穿刺失败,1例患者导丝无法通过桡动脉环。1例患者发生桡动脉痉挛,但通过带侧孔的鞘管注射硝酸甘油后立即缓解。6例患者出现皮下出血,但未发现明显血肿。5例患者发生桡动脉闭塞或狭窄,但所有病例均未观察到缺血症状。本研究表明,经桡动脉途径可以安全地进行选择性脑血管造影。

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