Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 2125, Los Angeles, CA, 90095-743730, USA.
Eur Radiol. 2019 Jan;29(1):68-74. doi: 10.1007/s00330-018-5580-2. Epub 2018 Jun 20.
The purpose of this study was to describe a single institution's experience with transradial access (TRA) for angiographic interventions, and to compare technical success, complication rate and radiation dose of procedures performed with TRA to those performed with transfemoral access (TFA).
A retrospective cohort study of patients undergoing peripheral interventions via TRA or TFA from 2015 to 2017 was performed. The cohort comprised 33 patients undergoing 44 procedures via TRA and 37 patients undergoing 44 procedures via TFA. Outcome measures were technical success, access-related complications, fluoroscopy time and radiation exposure. Differences at p < 0.05 were considered to be statistically significant.
Baseline characteristics were similar between patients who had procedures via TRA versus those who had procedures via TFA, including age, sex and body mass index. Technical success was achieved in 41/44 (93.2%) of procedures performed via TRA, compared to 44/44 (100%) of procedures performed via TFA (p = 0.241). There were three access-related complications (6.8%) when TRA was performed, compared to none when TFA was performed (p = 0.241). Fluoroscopy time was longer in procedures performed with TRA compared to those performed with TFA (27.3 vs 20.4, p = 0.033). Dose area product (DAP) did not differ with access site choice (p = 0.186).
TRA is a safe and feasible alternative to TFA for a range of peripheral interventions. However, TRA must be performed with prudence as it is not without complications and is technically challenging, leading to longer fluoroscopy time.
• Transradial access (TRA) is feasible in a variety of peripheral interventions, achieving success in 93.2% of cases. • Access-related complications are comparable between transfemoral access (TFA) and TRA (p = 0.241), but prudence must be taken during TRA as it could be technically challenging. • Procedures performed with TRA tend to have longer fluoroscopy time compared to those performed with TFA (p = 0.033), but the DAPs are comparable (p = 0.186).
本研究旨在描述一家机构在经桡动脉入路（TRA）进行血管造影介入治疗方面的经验，并比较经 TRA 和经股动脉入路（TFA）进行的手术的技术成功率、并发症发生率和辐射剂量。
回顾性分析了 2015 年至 2017 年期间接受经 TRA 或 TFA 外周介入治疗的患者队列。该队列包括 33 名接受 44 次 TRA 治疗和 37 名接受 44 次 TFA 治疗的患者。主要观察指标为技术成功率、与入路相关的并发症、透视时间和辐射暴露。p 值<0.05 被认为具有统计学意义。
TRA 组与 TFA 组患者的基线特征相似，包括年龄、性别和体重指数。TRA 组 44 次操作中，技术成功率为 41/44（93.2%），而 TFA 组 44 次操作中，技术成功率为 44/44（100%）（p=0.241）。TRA 组发生 3 例与入路相关的并发症（6.8%），而 TFA 组无此类并发症（p=0.241）。TRA 组的透视时间长于 TFA 组（27.3 比 20.4，p=0.033）。剂量面积乘积（DAP）与入路选择无关（p=0.186）。
TRA 是外周介入治疗的一种安全可行的 TFA 替代方法。然而，TRA 并非没有并发症，且技术上具有挑战性，因此必须谨慎使用，这可能导致透视时间延长。
• TRA 在外周介入的各种情况下都是可行的，成功率为 93.2%。• 经股动脉入路（TFA）和 TRA 之间的与入路相关的并发症相当（p=0.241），但在 TRA 期间必须谨慎，因为它在技术上可能具有挑战性。• 与 TFA 相比，TRA 组的透视时间往往较长（p=0.033），但 DAP 相当（p=0.186）。
