Department of Cardiology, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Chin Med J (Engl). 2012 Sep;125(18):3340-3.
Transfemoral artery access is the main approach for the interventional treatment of renal artery stenosis (RAS). This study aimed to investigate the technical feasibility of a transradial interventional (TRI) treatment of renal artery stenosis.
A series of 23 patients who underwent transradial renal artery stenting from October 2010 to October 2011 were studied. Radial sheath system (Terumo, Japan) was used to get access to the radial artery. Radial tourniquet (Terumo) was used to stop bleeding. A 5Fr MPA (COOK, USA) was used to perform selective renal arteriography. Percutaneous renal artery stent systems were used to perform renal artery stenting.
Renal artery angiography showed that 15 patients had unilateral renal artery stenosis and eight patients had bilateral renal artery stenosis. The descending aorta could not be catheterized in one patient because of the type III aortic arch. Twenty-two patients successfully underwent transradial renal artery angiography and the technical success rate was 95.7%. There was no puncture site hematoma or pseudoaneurysm. Mean procedure time was (38.4 ± 7.2) minutes, the mean amount of contrast agent used was (93.2 ± 6.3) ml, and the mean postprocedure bleeding time was (3.2 ± 1.9) minutes.
Transradial renal artery intervention is technically reliable with less invasion, rapid recovery, fewer complications and may become an alternative intervention approach for the treatment of renal artery stenosis.
股动脉入路是介入治疗肾动脉狭窄(RAS)的主要方法。本研究旨在探讨经桡动脉介入(TRI)治疗肾动脉狭窄的技术可行性。
研究了 2010 年 10 月至 2011 年 10 月期间 23 例接受经桡动脉肾动脉支架置入术的患者。采用 Terumo 公司(日本)的桡动脉鞘系统获得桡动脉入路,使用 Terumo 公司的桡动脉止血带止血。采用 5Fr MPA(COOK,美国)进行选择性肾动脉造影。采用经皮肾动脉支架系统进行肾动脉支架置入术。
肾动脉造影显示 15 例患者单侧肾动脉狭窄,8 例患者双侧肾动脉狭窄。由于 III 型主动脉弓,1 例患者无法进行降主动脉导管插入术。22 例患者成功进行了经桡动脉肾动脉造影,技术成功率为 95.7%。无穿刺部位血肿或假性动脉瘤。平均手术时间为(38.4±7.2)分钟,平均造影剂用量为(93.2±6.3)ml,平均术后出血时间为(3.2±1.9)分钟。
经桡动脉肾动脉介入术技术可靠,创伤小,恢复快,并发症少,可能成为治疗肾动脉狭窄的一种替代介入方法。