Baudouin C J, Belli A M, Peck R J, Cumberland D C
Department of Radiology, Royal Hallamshire Hospital, Sheffield.
Clin Radiol. 1990 Oct;42(4):277-80. doi: 10.1016/s0009-9260(05)82118-x.
Fifty-two angiograms via a high brachial puncture were performed in Sheffield from 1986 to 1988 in patients in whom femoral artery catheterization was not possible or was contraindicated. Follow-up was obtained in 49 procedures. The procedure was initially successful in 43 cases. Twelve patients developed haematomas, graded large in 5, but no intervention for haematoma was required. The radial pulse was diminished or absent at the end of examination in four patients; three of these patients had no associated ischaemia, the pulse returning spontaneously within 24 hours, although remaining chronically reduced in one patient. One patient developed ischaemia due to acute occlusion of the brachial artery--this was successfully treated with immediate angioplasty. Paraesthesiae in the median nerve distribution were noted in two patients. These resolved spontaneously and no permanent neurological problem was seen. We conclude that high brachial artery puncture is a useful alternative when femoral artery puncture is not possible.
1986年至1988年期间，在谢菲尔德对无法进行或禁忌进行股动脉插管的患者进行了52次经高位肱动脉穿刺的血管造影。49例手术获得了随访。该手术最初在43例中成功。12例患者出现血肿，其中5例为大血肿，但无需对血肿进行干预。4例患者在检查结束时桡动脉搏动减弱或消失；其中3例患者无相关缺血，脉搏在24小时内自发恢复，尽管有1例患者脉搏长期减弱。1例患者因肱动脉急性闭塞而出现缺血，经立即血管成形术成功治疗。2例患者出现正中神经分布区感觉异常。这些症状自发缓解，未出现永久性神经问题。我们得出结论，当无法进行股动脉穿刺时，高位肱动脉穿刺是一种有用的替代方法。
