Thakor Avnesh S, Alshammari Mohammed T, Liu David M, Chung John, Ho Stephen G F, Legiehn Gerald M, Machan Lindsay, Fischman Aaron M, Patel Rahul S, Klass Darren
Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Radiology, Stanford University Medical Center, Palo Alto, California, USA.
Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Interventional Radiology, Security Forces Hospital, Riyadh, Saudi Arabia.
Can Assoc Radiol J. 2017 Aug;68(3):318-327. doi: 10.1016/j.carj.2016.09.003. Epub 2017 Apr 7.
The study sought to describe a single centre's technical approach to transradial intervention and report on clinical outcomes and safety.
A total of 749 transradial access (TRA) procedures were performed at a single hospital in 562 patients (174 women and 388 men). Procedures included 445 bland embolizations or chemoembolizations of the liver, 88 uterine artery embolizations, and 148 procedures for Selective Internal Radiation Therapy (Y90), which included mapping and administration. The mean age of the patients was 62 years (range 27-96 years).
Four cases (0.5%) required crossover to transfemoral (tortuous anatomy, inability to secure a stable position for embolization, vessel spasm and base catheter not being of a sufficient length). A single asymptomatic, short-segment radial artery occlusion occurred (0.3%), 3 patients (0.4%) developed small hematomas postprocedurally, and 2 patients (0.7%) had transient neurological pain, which was resolved within a week without treatment. It was found that 98% of patients who had a previous femoral access procedure would choose radial access for subsequent procedures.
Transradial access is a safe, effective technique, with a learning curve; however, this procedure has the potential to significantly improve departmental workflow and cost savings for the department and patient experience.
本研究旨在描述单一中心经桡动脉介入治疗的技术方法，并报告临床结果和安全性。
在一家医院对562例患者（174例女性和388例男性）进行了总共749例经桡动脉穿刺（TRA）手术。手术包括445例肝脏单纯栓塞或化疗栓塞、88例子宫动脉栓塞以及148例选择性体内放射治疗（Y90）手术，其中包括定位和给药。患者的平均年龄为62岁（范围27 - 96岁）。
4例（0.5%）需要转为经股动脉途径（解剖结构迂曲、无法确保栓塞的稳定位置、血管痉挛以及基础导管长度不足）。发生1例无症状的短段桡动脉闭塞（0.3%），3例患者（0.4%）术后出现小血肿，2例患者（0.7%）出现短暂性神经疼痛，未经治疗在一周内缓解。发现98%既往接受过股动脉穿刺手术的患者会选择桡动脉途径进行后续手术。
经桡动脉途径是一种安全、有效的技术，存在学习曲线；然而，该手术有潜力显著改善科室工作流程，并为科室节省成本以及提升患者体验。
