Raghu Cherukupalli, Louvard Yves
Institut Cardiovasculaire Paris Sud, Massy, France.
Catheter Cardiovasc Interv. 2004 Apr;61(4):450-4. doi: 10.1002/ccd.20008.
Chronic mesenteric ischemia (CMI) occurs in the presence of slowly progressive, long-standing stenoses of the visceral arteries secondary to atherosclerosis. Angioplasty and stenting are emerging as therapeutic alternatives to surgery in treating CMI. The transradial approach is an attractive alternative access for performing stenting in CMI at improved safety and ease. A case of CMI treated with stenting of the visceral arteries by both transradial and femoral approaches is presented here. The main difficulty in accessing the celiac and mesenteric arteries through the femoral approach is the angle between the aorta and these vessels, which often leads the operator to use multiple catheters. The main advantage of the radial approach (as well as the brachial one) is that it allows easy coaxial alignment of the catheter with the artery. The main problem is the inadequate length of the currently available catheters. The radial approach eliminates the risk for vascular complications and permits early ambulation.
慢性肠系膜缺血（CMI）发生于因动脉粥样硬化继发的内脏动脉缓慢进展、长期存在的狭窄情况。血管成形术和支架置入术正在成为治疗CMI的手术替代治疗方法。经桡动脉途径是一种有吸引力的替代入路，用于CMI的支架置入，安全性更高且操作更简便。本文介绍了一例通过经桡动脉和股动脉途径进行内脏动脉支架置入治疗的CMI病例。经股动脉途径进入腹腔干和肠系膜动脉的主要困难在于主动脉与这些血管之间的角度，这常常导致操作者使用多个导管。桡动脉途径（以及肱动脉途径）的主要优点是它能使导管与动脉轻松同轴对齐。主要问题是目前可用导管的长度不足。桡动脉途径消除了血管并发症的风险，并允许早期下床活动。
