Valsecchi Orazio, Vassileva Angelina, Musumeci Giuseppe, Rossini Roberta, Tespili Maurizio, Guagliumi Giulio, Mihalcsik Laurian, Gavazzi Antonello, Ferrazzi Paolo
Interventional Cath Lab, Cardiovascular Department, Ospedali Riuniti of Bergamo, Italia.
Catheter Cardiovasc Interv. 2006 Jun;67(6):870-8. doi: 10.1002/ccd.20732.
The anatomy of the radial artery has yet to be systematically studied from the perspective of using it as a route for catheter access. We prospectively performed angiography of the arteries of the upper limb to delineate the anatomic features of the radial artery as a way to determine the feasibility of using it as a route for coronary intervention. We studied 2,211 consecutive patients submitted to transradial cardiac catheterization. In all patients, an angiography of the upper limb arteries was performed before and after procedure. Radial puncture was successful in 98.9% of patients. At angiography, anatomic variations of upper limb arteries were noted in 505 patients (22.8%) and included tortuous configurations (3.8%), stenosis (1.7%), hypoplasias (7.7%), radioulnar loop (0.8%), abnormal origin of the radial artery (8.3%), and lusoria subclavian artery (0.45%). Overall procedural success by transradial approach was 97.5%. Patients with anatomic variations of radial artery had a significantly lower puncture (96.2% vs 99.7%, P < 0.0001) and procedural (93.1% vs 98.8%, P < 0.0001) success. The procedure was successfully performed by radial approach in 98.8% of patients with tortuous configurations, 91.9% of radial stenosis, 93.9% of hypoplastic radial artery, 83.3% of radioulnar loop, 96.7% of radial axillary origin, and 60% of lusoria subclavian artery setting. Anatomic variations of the radial artery are not rare. However, they do not represent an important limitation in transradial approach if they are well documented previously.
从将桡动脉用作导管接入途径的角度来看，其解剖结构尚未得到系统研究。我们前瞻性地对上肢动脉进行血管造影，以描绘桡动脉的解剖特征，从而确定将其用作冠状动脉介入途径的可行性。我们研究了连续2211例接受经桡动脉心脏导管插入术的患者。在所有患者中，术前和术后均进行了上肢动脉血管造影。98.9%的患者桡动脉穿刺成功。血管造影时，505例患者（22.8%）发现上肢动脉解剖变异，包括迂曲形态（3.8%）、狭窄（1.7%）、发育不全（7.7%）、桡尺环（0.8%）、桡动脉异常起源（8.3%）和迷走锁骨下动脉（0.45%）。经桡动脉途径的总体手术成功率为97.5%。桡动脉解剖变异的患者穿刺成功率（96.2%对99.7%，P<0.0001）和手术成功率（93.1%对98.8%，P<0.0001）显著较低。在98.8%的迂曲形态患者、91.9%的桡动脉狭窄患者、93.9%的桡动脉发育不全患者、83.3%的桡尺环患者、96.7%的桡动脉腋部起源患者和60%的迷走锁骨下动脉患者中，经桡动脉途径成功完成了手术。桡动脉的解剖变异并不罕见。然而，如果之前有充分记录，它们在经桡动脉途径中并不代表重要限制。
