Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
J Interv Cardiol. 2011 Oct;24(5):397-400. doi: 10.1111/j.1540-8183.2011.00668.x. Epub 2011 Aug 25.
The transradial approach has several pitfalls that include problems regarding the radial puncture and difficulties with the catheter technique. We evaluated whether external side-compression of radial artery was helpful to yield the success rate for advancement of guidewires under the presence of side branches or arterial tortuosity.
The study population consisted of 11 patients with unsuccessful advancement of guidewires into the brachial artery. In 7 patients, the J-tip hydrophilic guidewire was not advanced into the brachial artery because it always directed into the side branch. During external side-compression of radial artery at the culprit site with a finger of the second operator, the guidewire was successfully advanced into the brachial artery in all patients. In 4 patients, the guidewire was not advanced into the brachial artery because the radial artery was tortuous. During external side-compression of radial artery at the culprit site, the guidewire was successfully advanced into the brachial artery in 2 patients. In the remaining 2 patients in whom this attempt was unsuccessful, coronary angiography was performed through the right brachial artery. Overall success rate of this technique was 82%.
External side-compression of radial artery is an easy and feasible technique for difficulties in the advancement of guidewires due to the presence of side branches or arterial tortuosity.
经桡动脉入路存在一些问题，包括桡动脉穿刺困难和导管技术困难。我们评估了在存在侧支或动脉迂曲的情况下，对外侧桡动脉进行侧方压迫是否有助于提高导丝推进的成功率。
研究人群包括 11 例导丝未能进入肱动脉的患者。在 7 例患者中，由于 J 型亲水导丝总是指向侧支，因此无法将其推进肱动脉。在第二操作者的手指对有问题的桡动脉进行外侧压迫时，所有患者的导丝均成功进入肱动脉。在 4 例患者中，由于桡动脉迂曲，导丝无法进入肱动脉。在有问题的桡动脉处进行外侧压迫时，导丝成功进入肱动脉 2 例。在另外 2 例尝试不成功的患者中，通过右侧肱动脉进行冠状动脉造影。该技术的总体成功率为 82%。
对于由于存在侧支或动脉迂曲导致导丝推进困难的情况，外侧桡动脉压迫是一种简单可行的技术。
