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经桡动脉途径用于经皮冠状动脉及非冠状动脉介入治疗

[Transradial access for percutaneous coronary and non-coronary interventions].

作者信息

Lorenzoni Roberto, Lazzari Mauro, Boni Andrea, Gemignani Cristina, Bovenzi Francesco Maria

机构信息

U.O. di Cardiologia, Ospedale Campo di Marte, Lucca.

出版信息

G Ital Cardiol (Rome). 2011 Jun;12(6):419-27. doi: 10.1714/835.9307.

Abstract

The transfemoral access is still the most widely used approach for percutaneous coronary and non-coronary interventions. However, the transradial access has been increasingly used, mostly because it is associated with less hemorrhagic complications. The present review is aimed at evaluating the use of the transradial access for percutaneous vascular interventions. In many institutions, the radial artery is already the preferred vascular access for coronary procedures for routine coronary angiography but also for complex interventions such as primary angioplasty and angioplasty for stenosis at coronary bifurcations or coronary bypass grafts, or for treating chronic coronary occlusions. The radial artery can be used also as a vascular access for percutaneous peripheral interventions. Supra-aortic vessels (carotid, subclavian and vertebral arteries) can be treated via the radial route when obstructions of the femoro-iliac tract preclude groin access or also to circumvent anatomic variations such as bovine aortic arch. For renal artery angioplasty, the transradial access can be considered ideal for anatomic reasons, at least for those operators who use this access routinely for coronary interventions. At present, the transradial access can also be used, although in specific cases, to treat stenosis of the lower limb arteries in above the knee segments.

摘要

经股动脉途径仍是经皮冠状动脉介入和非冠状动脉介入中使用最广泛的方法。然而,经桡动脉途径的使用越来越多,主要是因为它与较少的出血并发症相关。本综述旨在评估经桡动脉途径在经皮血管介入中的应用。在许多机构中,桡动脉已经是冠状动脉造影常规冠状动脉手术以及复杂介入手术(如直接血管成形术、冠状动脉分叉处狭窄或冠状动脉旁路移植术的血管成形术,或治疗慢性冠状动脉闭塞)中首选的血管入路。桡动脉也可作为经皮外周介入的血管入路。当股-髂段梗阻妨碍腹股沟入路时,或为规避诸如牛主动脉弓等解剖变异时,可通过桡动脉途径治疗主动脉弓上血管(颈动脉、锁骨下动脉和椎动脉)。对于肾动脉血管成形术,出于解剖学原因,经桡动脉途径可被认为是理想的,至少对于那些常规使用该入路进行冠状动脉介入的操作者来说是这样。目前,经桡动脉途径也可用于治疗膝上节段的下肢动脉狭窄,尽管是在特定情况下。

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