Li Chengzhi, You Huimin, Zhang Hong, Liu Yulong, Li Wanghai, Wang Xiaobai, Zhang Yan
Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
Department of Endocrinology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
PeerJ. 2019 Feb 13;7:e6345. doi: 10.7717/peerj.6345. eCollection 2019.
This study aimed to introduce and evaluate the safety and efficacy of the relay puncture technique in patients with complicated lower extremity arterial diseases.
A total of 21 patients (16 male and five female patients; median age: 68.5 years old), who had suffered from lower extremity arterial diseases between December 2014 and July 2017, were retrospectively collected. For all patients, the contralateral femoral artery was not available for puncture access, and the length of the devices was too short for the brachial artery approach. Therefore, the relay puncture technique, in which the first puncture was performed on the brachial artery, followed by an antegrade puncture on the femoral artery, was used to accomplish the endovascular therapy. Percutaneous transluminal angioplasty and/or percutaneous transluminal stenting were/was used to assess the efficacy of the relay puncture technique. The ankle-brachial index (ABI) and Rutherford clinical classification were used to evaluate the improvement of symptoms after treatment. Patients were followed up for 1, 3, 6, and 12 months, and annually (mean: 16.6 months) after discharge.
The relay puncture treatment had a 100% technical success rate, and immediately decreased the ischemic symptoms of patients after the procedure. The ABI significantly increased from 0.33 ± 0.18 to 0.75 ± 0.21 at the 1-year follow-up time point ( < 0.05). No serious complications occurred during the follow-up period. The 1-year primary patency rate was 71.43%.
The relay puncture technique is a feasible technique in the hands of experienced and skilled equipment operators for the treatment of lower extremity arterial diseases, when the contralateral femoral artery is not available for puncture, and the length of the device is too short to treat the distal lesion of the femoral artery and popliteal artery through the brachial artery approach.
本研究旨在介绍并评估接力穿刺技术在复杂下肢动脉疾病患者中的安全性和有效性。
回顾性收集了2014年12月至2017年7月期间患有下肢动脉疾病的21例患者（16例男性和5例女性患者；中位年龄：68.5岁）。所有患者的对侧股动脉无法用于穿刺，且器械长度过短无法采用肱动脉入路。因此，采用接力穿刺技术，即先在肱动脉进行首次穿刺，然后在股动脉进行顺行穿刺，以完成血管内治疗。采用经皮腔内血管成形术和/或经皮腔内支架置入术评估接力穿刺技术的疗效。采用踝肱指数（ABI）和卢瑟福临床分级评估治疗后症状的改善情况。患者在出院后1、3、6和12个月以及每年（平均：16.6个月）进行随访。
接力穿刺治疗技术成功率为100%，术后立即减轻了患者的缺血症状。在1年随访时间点，ABI从0.33±0.18显著增加至0.75±0.21（P<0.05）。随访期间未发生严重并发症。1年原发性通畅率为71.43%。
当对侧股动脉无法用于穿刺且器械长度过短无法通过肱动脉入路治疗股动脉和腘动脉远端病变时，接力穿刺技术对于经验丰富且技术熟练的设备操作人员来说，是一种治疗下肢动脉疾病的可行技术。
