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尸体桡动脉、肱动脉和锁骨下动脉的形态学评估:一种神经介入方法。

Morphological Assessment of Cadaveric Radial, Brachial and Subclavian Arteries: A Neurointerventional Approach.

作者信息

Yilmaz Ali, Ozkul Ayca, Shin Dong Seong, Im Soo-Bin, Yoon Seok-Mann, Kim Bum-Tae

机构信息

Department Neurosurgery, Adnan Menderes University Faculty of Medicine, Aydin, Turkey.

Department Neurology, Adnan Menderes University Faculty of Medicine, Aydin, Turkey.

出版信息

J Korean Neurosurg Soc. 2015 Dec;58(6):499-503. doi: 10.3340/jkns.2015.58.6.499. Epub 2015 Dec 31.

Abstract

OBJECTIVE

The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery.

METHODS

Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured.

RESULTS

The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was 13.41±2.19 mm, and the RSP was 26.85±2.47 mm from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as 44.23±5.47 mm, whereas the distance between the ME and the MN was 42.23±4.77 mm. The average VAO-ScA angle was 70.94±6.12°, and the length between the ScA junction (SCJ) and the VAO was 60.30±8.48 mm.

CONCLUSION

This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.

摘要

目的

经桡动脉导管插入术(TRC)正日益普及,主要用于神经介入治疗。因此,在临床实践中评估桡动脉穿刺并更好地了解其解剖结构对于提高神经血管内手术的安全性很重要。

方法

对10具用福尔马林固定的成年韩国尸体进行解剖,双侧暴露桡动脉(RA)、肱动脉(BrA)和锁骨下动脉(ScA)。使用卡尺测量血管长度和直径,并测量血管特定点与包括桡骨茎突、肱骨内上髁、胸锁关节和椎动脉开口在内的解剖标志之间的距离。

结果

桡动脉穿刺点(RAPS)与肱动脉穿刺点(BrAPS)之间以及椎动脉开口(VAO)与肱动脉分叉处(BrAB)之间的平均长度在两侧之间无差异(p>0.05)。桡骨茎突(RSP)与RAPS之间的平均长度为13.41±2.19毫米,RSP距正中神经(MN)为26.85±2.47毫米。肱骨内上髁(ME)与BrAPS之间的平均长度为44.23±5.47毫米,而ME与MN之间的距离为42.23±4.77毫米。VAO-ScA平均角度为70.94±6.12°,锁骨下动脉交界处(SCJ)与VAO之间的长度为60.30±8.48毫米。

结论

本研究提供了有关桡动脉和肱动脉路径的基本解剖信息,有助于改进新技术,选择TRC导管的尺寸和形状。这可以帮助采用经桡动脉神经血管内入路的神经介入医生为患者提供全面、安全的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c2c/4728085/7979eefc82d8/jkns-58-499-g001.jpg

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