Lorenzoni Roberto, Lisi Cristiano, Corciu Anca, Lazzari Mauro, Bovenzi Francesco
1 Cardiovascular Department, San Luca Hospital, Lucca, Italy.
J Endovasc Ther. 2014 Oct;21(5):635-40. doi: 10.1583/14-4747R.1.
To report the results and complications of a single-center experience of above-the-knee angioplasty via transradial access (TRA).
In a prospective study, 110 consecutive patients (88 men; mean age 72 years, range 37-90) referred for critical limb ischemia (26, 24%) or claudication were eligible for lower limb angioplasty via TRA (patients with TASC D lesions of the superficial femoral artery and below-the-knee lesions were excluded).
The majority of patients (84, 76%) were treated via a left TRA. A total of 170 lesions were addressed, of which 38 (22%) were occlusions; 113 stents were positioned in 82 patients. The overall technical success rate was 91%, with a 63% success rate in occlusions and a 98% success rate in stenoses; by location, the success rates were 91% in suprainguinal lesions and 90% in infrainguinal lesions. No hemorrhagic or local complications requiring surgery were observed. At 1-month follow-up, 101 patients had a downward shift of at least one category in the Rutherford classification of symptoms (clinical success rate 92%); 18 (16%) patients had occlusion of their access radial artery, but none had symptoms or discomfort.
The present study demonstrates that TRA is a safe and effective approach for lower extremity arterial revascularization, at least for interventionists with longstanding experience in TRA and in selected anatomical subsets.
报告单中心经桡动脉入路（TRA）行膝上血管成形术的结果及并发症。
在一项前瞻性研究中，110例因严重肢体缺血（26例，24%）或间歇性跛行而连续入选的患者（88例男性；平均年龄72岁，范围37 - 90岁）符合经TRA行下肢血管成形术的条件（排除股浅动脉TASC D病变及膝下病变患者）。
大多数患者（84例，76%）通过左TRA进行治疗。共处理了170处病变，其中38处（22%）为闭塞病变；82例患者置入了113枚支架。总体技术成功率为91%，闭塞病变成功率为63%，狭窄病变成功率为98%；按部位划分，腹股沟上病变成功率为91%，腹股沟下病变成功率为90%。未观察到需要手术处理的出血或局部并发症。在1个月的随访中，101例患者的症状在卢瑟福分类中至少下降了一个等级（临床成功率92%）；18例（16%）患者的桡动脉入路发生闭塞，但均无相关症状或不适。
本研究表明，TRA是下肢动脉血运重建的一种安全有效的方法，至少对于有TRA长期经验的介入医生以及特定解剖亚组的患者是如此。
