Shin Dong-Seong, Yeo Dong-Kyu, Hwang Sun-Chul, Park Sukh-Que, Kim Bum-Tae
Department of Neurosurgery, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.
J Korean Neurosurg Soc. 2013 Aug;54(2):81-5. doi: 10.3340/jkns.2013.54.2.81. Epub 2013 Aug 31.
Transfemoral catheter angiography (TFCA) is a basic procedure in neurovascular surgery with increasing importance in surgical and non-invasive treatments. Unfortunately, resident neurosurgeons have relatively few opportunities to perform TFCA in most institutions. We report a method developed in our hospital for training resident neurosurgeons to perform TFCA and evaluate the efficacy of this training.
From May 2011 to September 2011, a total of 112 consecutive patients underwent TFCA by one resident neurosurgeon supervised by two neuroendovascular specialists. Patients who underwent elective diagnostic procedures were included in this study. Patients who underwent endovascular treatment were excluded. Demographic data, indications for TFCA, side of approach, number of selected arteries, and complications were analyzed.
This study included 64 males and 48 females with a mean age of 51.6 (12-81) years. All procedures were performed in the angiography suite. Common indications for procedures were as follows: stroke-induced symptoms in 61 patients (54.5%), Moyamoya disease and arteriovenous malformation in 13 patients (11.6%), and unruptured intracranial aneurysm in eight patients (7.1%). Right and left femoral puncture was performed in 98.2% and 1.8% of patients, respectively. A total of 465 selective angiographies were performed without complications. Angiographic examination was performed on 4.15 vessels per patient.
TFCA can be performed safely by resident neurosurgeons based on anatomical study and a meticulous protocol under the careful supervision of neuroendovascular specialists.
经股动脉导管血管造影术(TFCA)是神经血管外科的一项基本操作,在外科治疗和非侵入性治疗中的重要性日益增加。不幸的是,在大多数机构中,住院神经外科医生进行TFCA的机会相对较少。我们报告了我院开发的一种培训住院神经外科医生进行TFCA的方法,并评估了该培训的效果。
2011年5月至2011年9月,共有112例连续患者在两名神经血管内介入专家的监督下由一名住院神经外科医生进行了TFCA。本研究纳入了接受择期诊断性操作的患者。接受血管内治疗的患者被排除在外。分析了人口统计学数据、TFCA的适应证、入路侧、所选动脉数量和并发症。
本研究包括64例男性和48例女性,平均年龄51.6(12 - 81)岁。所有操作均在血管造影室进行。操作的常见适应证如下:61例患者(54.5%)出现中风相关症状,13例患者(11.6%)患有烟雾病和动静脉畸形,8例患者(7.1%)患有未破裂颅内动脉瘤。分别有98.2%和1.8%的患者进行了右股动脉和左股动脉穿刺。共进行了465次选择性血管造影,无并发症发生。每位患者平均进行了4.15次血管造影检查。
在神经血管内介入专家的仔细监督下,住院神经外科医生基于解剖学研究和细致的操作流程能够安全地进行TFCA。