UO Cardiologia, Ospedale Campo di Marte, Lucca, Italy.
EuroIntervention. 2011 Dec;7(8):924-9. doi: 10.4244/EIJV7I8A146.
Lower limb angioplasty is usually performed by transfemoral access despite the risk of local complications. Transradial access (TRA) has gained acceptance for coronary interventions. The aim of this study was to evaluate the feasibility and safety of TRA for above the knee (ATK) angioplasty.
Twenty-five consecutive patients (eight females; mean age 72, range 55-85 years; seven symptomatic for critical limb ischaemia, 18 for claudication) underwent ATK angioplasty by left (19) or right (6) TRA. A total of 32 lesions were addressed; 16 stents were positioned in 12 patients with an overall success rate of 81%, and a success rate of 38% on occlusions and of 96% on stenoses. The overall success rate on the 16 supra-inguinal lesions was 81%, (success rate 60% on occlusions and 91% on stenoses). The overall success rate on the 16 infra-inguinal lesions was 81%, (success rate 0% on occlusions and 100% on stenoses). Any haemorrhagic complications or local complications needing surgery were observed in the cohort of patients.
TRA can represent a feasible and safe alternative for ATK angioplasty in case of difficult femoral access.
尽管下肢血管成形术经股动脉入路有发生局部并发症的风险，但通常仍采用该方法。经桡动脉入路（TRA）已被广泛接受用于冠状动脉介入治疗。本研究旨在评估经桡动脉入路用于膝上（ATK）血管成形术的可行性和安全性。
25 例连续患者（8 例女性；平均年龄 72 岁，范围 55-85 岁；7 例因临界肢体缺血而出现症状，18 例因跛行而出现症状）接受了左（19 例）或右（6 例）TRA 的 ATK 血管成形术。共处理了 32 处病变；12 例患者共放置了 16 个支架，总体成功率为 81%，闭塞病变成功率为 38%，狭窄病变成功率为 96%。16 处腘上病变的总体成功率为 81%（闭塞病变成功率为 60%，狭窄病变成功率为 91%）。16 处腘下病变的总体成功率为 81%（闭塞病变成功率为 0%，狭窄病变成功率为 100%）。未观察到该组患者有任何出血性并发症或需要手术的局部并发症。
在股动脉入路困难的情况下，TRA 可作为膝上血管成形术的一种可行且安全的替代方法。
