Quebec Heart-Lung Institute, Quebec, Canada.
JACC Cardiovasc Interv. 2010 Oct;3(10):1022-31. doi: 10.1016/j.jcin.2010.07.013.
The aim of this study was to evaluate practice of transradial approach (TRA).
TRA has been adopted as an alternative access site for coronary procedures.
A questionnaire was distributed worldwide with Internet-based software.
The survey was conducted from August 2009 to January 2010 among 1,107 interventional cardiologists in 75 countries. Although pre-TRA dual hand circulation testing is not uniform in the world, >85% in the U.S. perform Allen or oximetry testing. Right radial artery is used in almost 90%. Judkins catheters are the most popular for left coronary artery angiographies (66.5%) and right coronary artery angiographies (58.8%). For percutaneous coronary intervention (PCI), 6-F is now standard. For PCI of left coronary artery, operators use standard extra back-up guiding catheters in >65% and, for right coronary artery 70.4% use right Judkins catheters. Although heparin remains the routine antithrombotic agent in the world, bivalirudin is frequently used in the U.S. for PCI. The incidence of radial artery occlusion before hospital discharge is not assessed in >50%. Overall, approximately 50% responded that their TRA practice will increase in the future (68.4% in the U.S.).
TRA is already widely used across the world. Diagnostic and guiding-catheters used for TRA remain similar to those used for traditional femoral approach, suggesting that specialized radial catheters are not frequently used. However, there is substantial variation in practice as it relates to specific aspects of TRA, suggesting that more data are needed to determine the optimal strategy to facilitate TRA and optimize radial artery patency after catheterization.
本研究旨在评估经桡动脉入路（TRA）的应用实践。
TRA 已被采纳为冠状动脉介入治疗的替代入路。
我们使用基于互联网的软件在全球范围内分发问卷。
该调查于 2009 年 8 月至 2010 年 1 月期间在 75 个国家的 1107 名介入心脏病学家中进行。尽管全球范围内 TRA 术前双侧手部循环检测并不统一，但美国有超过 85%的术者进行 Allen 或血氧饱和度检测。近 90%的术者使用右侧桡动脉。左冠状动脉造影（66.5%）和右冠状动脉造影（58.8%）最常使用 Judkins 导管。对于经皮冠状动脉介入治疗（PCI），目前标准为 6-F。对于左冠状动脉 PCI，超过 65%的术者使用标准的额外备用导引导管，对于右冠状动脉，70.4%的术者使用右 Judkins 导管。尽管肝素仍是全球常规抗血栓药物，但在美国，比伐卢定常用于 PCI。超过 50%的术者未在出院前评估桡动脉闭塞的发生率。总体而言，约 50%的术者表示未来他们的 TRA 实践将增加（美国为 68.4%）。
TRA 已在全球范围内广泛应用。TRA 中使用的诊断和导引导管与传统股动脉入路中使用的导引导管相似，这表明并未经常使用专门的桡动脉导管。然而，TRA 的具体实践方面存在较大差异，这表明需要更多的数据来确定促进 TRA 和优化导管介入后桡动脉通畅性的最佳策略。
