经桡动脉心导管术后严重手部缺血：一种常见操作的罕见并发症。
Critical hand ischaemia after transradial cardiac catheterisation: an uncommon complication of a common procedure.
机构信息
Department of Cardiology, Catharina-ziekenhuis, Michelangelolaan 2, 5623, EJ, Eindhoven, the Netherlands,
出版信息
Neth Heart J. 2012 Sep;20(9):372-5. doi: 10.1007/s12471-012-0276-8.
Abstract
We describe a case of critical hand ischaemia after transradial cardiac catheterisation. The patient presented with hand ischaemia 5 days after transradial coronary angiography. Urgent angiography demonstrated radial artery occlusion with embolisation to the palmar arch and digital arteries. The ischaemia was refractory to an extensive thrombolytic regimen, and subsequently, the patient was referred to the vascular surgeon for urgent thrombectomy and patch angioplasty. The patient recovered slowly and no amputation was necessary, but complaints of right hand numbness and paresthesia of all digits remained.
摘要
我们描述了一例经桡动脉心导管术后严重手部缺血的病例。患者在经桡动脉冠状动脉造影后 5 天出现手部缺血。紧急血管造影显示桡动脉闭塞，并向掌弓和指动脉栓塞。缺血对广泛的溶栓方案无反应，随后患者被转介给血管外科医生进行紧急血栓切除术和补片血管成形术。患者恢复缓慢，但无需截肢，但仍有右手麻木和所有手指感觉异常的抱怨。
相似文献
1
Critical hand ischaemia after transradial cardiac catheterisation: an uncommon complication of a common procedure.
Neth Heart J. 2012 Sep;20(9):372-5. doi: 10.1007/s12471-012-0276-8.
2
Radial artery pseudoaneurysms after transradial cardiac catheterisation.
Vasa. 2016;45(3):229-32. doi: 10.1024/0301-1526/a000529.
3
Transulnar versus transradial approach for coronary angiography and angioplasty: Considering their complications.
ARYA Atheroscler. 2018 May;14(3):128-131. doi: 10.22122/arya.v14i3.1586.
5
Retrograde subintimal recanalization of a radial artery occlusion after coronary angiography using the palmar loop technique.
Cardiovasc Revasc Med. 2015 Jun;16(4):259-61. doi: 10.1016/j.carrev.2014.12.002. Epub 2014 Dec 29.
6
[Vascular complications of percutaneous transradial coronary angiography and coronary intervention].
Med Klin (Munich). 2005 Jul 15;100(7):377-82. doi: 10.1007/s00063-005-1049-6.
7
When one complication begets another - A case report of radial artery pseudoaneurysm following radial artery occlusion post-transradial coronary angiography.
J Cardiol Cases. 2020 Apr 25;22(2):52-54. doi: 10.1016/j.jccase.2020.04.003. eCollection 2020 Aug.
8
The ACRA Anatomy Study (Assessment of Disability After Coronary Procedures Using Radial Access): A Comprehensive Anatomic and Functional Assessment of the Vasculature of the Hand and Relation to Outcome After Transradial Catheterization.
Circ Cardiovasc Interv. 2017 Nov;10(11). doi: 10.1161/CIRCINTERVENTIONS.117.005753.
9
Percutaneous transradial coronary angiography and angioplasty in patients with occlusive atherosclerotic iliofemoral disease.
Scand Cardiovasc J. 2000;34(1):84-6. doi: 10.1080/14017430050142459.
10
Non-invasive assessment of the collateral circulation in the hand: validation of the Nexfin system and relation to clinical outcome after transradial catheterisation.
EuroIntervention. 2017 Feb 20;12(14):1773-1781. doi: 10.4244/EIJ-D-16-00337.
引用本文的文献
1
Accessory Brachial Artery Causing Delayed Vasospasm After Angiography: A Detailed Analysis of a Case Report.
Cureus. 2025 Jun 17;17(6):e86238. doi: 10.7759/cureus.86238. eCollection 2025 Jun.
2
Feasibility and radial artery occlusion rate of sheathless distal transradial access using balloon guide catheters.
Neurosurg Rev. 2024 Oct 14;47(1):795. doi: 10.1007/s10143-024-02994-w.
3
Incidence and Prognostic Factors of Radial Artery Occlusion in Transradial Coronary Catheterization.
J Clin Med. 2024 Jun 1;13(11):3276. doi: 10.3390/jcm13113276.
4
Radial Artery Reconstruction After Iatrogenic Cannulation-Related Occlusion: A Case Report.
Cureus. 2024 Apr 13;16(4):e58214. doi: 10.7759/cureus.58214. eCollection 2024 Apr.
5
Comparison of the Efficacy of Two Elastic Bandages for Forearm Hematoma After Transradial Coronary Intervention.
Front Surg. 2021 Sep 16;8:709489. doi: 10.3389/fsurg.2021.709489. eCollection 2021.
6
Acute Hand Ischemia and Digital Amputation After Transradial Coronary Intervention in a Patient With CREST Syndrome.
Tex Heart Inst J. 2020 Aug 1;47(4):319-321. doi: 10.14503/THIJ-19-6988.
7
A Comparative Analysis between Ultrasound-Guided and Conventional Distal Transradial Access for Coronary Angiography and Intervention.
J Interv Cardiol. 2020 Sep 8;2020:7342732. doi: 10.1155/2020/7342732. eCollection 2020.
8
Access-site Complications of the Transradial Approach: Rare But Still There.
Curr Cardiol Rev. 2021;17(3):279-293. doi: 10.2174/1573403X16999200819101923.
9
Complex Large-Bore Radial percutaneous coronary intervention: rationale of the COLOR trial study protocol.
BMJ Open. 2020 Jul 20;10(7):e038042. doi: 10.1136/bmjopen-2020-038042.
10
Iatrogenic Radial Artery Injuries: Variable Injury Patterns, Treatment Times, and Outcomes.
Hand (N Y). 2021 Jan;16(1):93-98. doi: 10.1177/1558944719844348. Epub 2019 May 1.
本文引用的文献
1
The transradial approach. An increasingly used standard for coronary diagnosis and interventions.
Herz. 2011 Aug;36(5):386-95. doi: 10.1007/s00059-011-3483-y.
2
Transradial cardiac catheterization: a review of access site complications.
Catheter Cardiovasc Interv. 2011 Nov 15;78(6):840-6. doi: 10.1002/ccd.22978. Epub 2011 May 12.
3
Hand ischemia resulting from a transradial intervention: successful management with radial artery angioplasty.
Catheter Cardiovasc Interv. 2010 Sep 1;76(3):383-6. doi: 10.1002/ccd.22460.
4
A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty.
JACC Cardiovasc Interv. 2009 Nov;2(11):1047-54. doi: 10.1016/j.jcin.2009.07.016.
5
Radial artery cannulation: a comprehensive review of recent anatomic and physiologic investigations.
Anesth Analg. 2009 Dec;109(6):1763-81. doi: 10.1213/ANE.0b013e3181bbd416.
6
Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of Early Invasive and Conservative Treatment in Patients With Non-ST-ElevatiOn Acute Coronary Syndromes [PRESTO-ACS] Vascular Substudy).
Am J Cardiol. 2009 Mar 15;103(6):796-800. doi: 10.1016/j.amjcard.2008.11.049. Epub 2009 Jan 24.
7
Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials.
Am Heart J. 2009 Jan;157(1):132-40. doi: 10.1016/j.ahj.2008.08.023. Epub 2008 Nov 1.
8
Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg).
Heart. 2008 Aug;94(8):1019-25. doi: 10.1136/hrt.2007.136390. Epub 2008 Mar 10.
9
Prevention and management of radial artery spasm.
J Invasive Cardiol. 2006 Apr;18(4):159-60.
10
Hand ischemia after radial artery cannulation.
J Am Coll Surg. 2005 Jul;201(1):18-22. doi: 10.1016/j.jamcollsurg.2005.01.011.
Zotero 插件