Mortensen Chloe, Chung John, Liu David, Ho Stephen, Legiehn Gerald, Machan Lindsay, Klass Darren
Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
University of British Columbia, Vancouver, Canada.
Cardiovasc Intervent Radiol. 2019 Mar;42(3):441-447. doi: 10.1007/s00270-018-2100-3. Epub 2018 Oct 29.
Comparing total fluoroscopy time (FT) to perform uterine artery embolization (UAE) with transradial approach (TRA) versus transfemoral approach (TFA). Our hypothesis was that there would be no significant procedural time penalty incurred, despite the learning curve associated with adopting a new approach.
A cohort study was undertaken including 66 consecutive patients undergoing UAE with either TRA/TFA between January and September 2015. Total FT was recorded prospectively for each procedure, and data subsequently analyzed retrospectively. Each operator had at least 2 years of experience as an interventional radiologist having performed at least 200 TFA UAEs. All operators had recently incorporated TRA into their practice.
A total of 39 TFA and 27 TRA cases were included in the study; mean age for TFA group was 44.4 years (± 4.9) and for TRA group was 45.1 years (± 4.9) (p = 0.59). Mean FTs were comparable between the two groups (p = 0.86) despite a learning curve associated with TRA: The mean total FT with TFA was 20.36 min (± 9.48) compared to TRA 20.12 min (± 7.67).
FTs for TRA UAE were comparable to TFA UAE, even though TRA had been recently adopted as a new approach. Despite the learning curve associated with developing a novel technique, operators should not expect the efficiency of their service to be significantly compromised. Introducing this safe and effective method of vascular access should therefore be considered.
比较经桡动脉途径(TRA)与经股动脉途径(TFA)进行子宫动脉栓塞术(UAE)的总透视时间(FT)。我们的假设是,尽管采用新方法存在学习曲线,但不会导致显著的操作时间延长。
进行了一项队列研究,纳入了2015年1月至9月期间连续66例行TRA/TFA UAE的患者。前瞻性记录每个手术的总FT,随后进行回顾性数据分析。每位操作者作为介入放射科医生至少有2年经验,且至少进行过200例TFA UAE。所有操作者最近都将TRA纳入了他们的操作中。
本研究共纳入39例TFA和27例TRA病例;TFA组的平均年龄为44.4岁(±4.9),TRA组为45.1岁(±4.9)(p = 0.59)。尽管TRA存在学习曲线,但两组的平均FT相当(p = 0.86):TFA的平均总FT为20.36分钟(±9.48),而TRA为20.12分钟(±7.67)。
TRA UAE的FT与TFA UAE相当,即使TRA是最近才采用的新方法。尽管开发新技术存在学习曲线,但操作者不应期望其服务效率会受到显著影响。因此,应考虑引入这种安全有效的血管通路方法。