避免动脉介入治疗中的周围神经损伤。
Avoiding peripheral nerve injury in arterial interventions.
机构信息
Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;Department of Radiology, VA Greater Los Angeles Healthcare System, Los Angeles, California.
出版信息
Diagn Interv Radiol. 2019 Sep;25(5):380-391. doi: 10.5152/dir.2019.18296.
Although peripheral nerve injuries secondary to angiography and endovascular interventions are uncommon and usually not permanent, they can result in significant functional impairment. Most arteries used in access for angiography and endovascular therapies lie in close proximity to a nerve. The nerve may be injured by needle puncture, or by compression from hematoma, pseudoaneurysm, hemostasis devices, or by manual compression with incidence in literature ranging from as low as 0.04% for femoral access in a large retrospective study to 9% for brachial and axillary access. Given the increasing frequency of endovascular arterial procedures and the increasing use of nontraditional access points, it is important that the interventionalist have a working knowledge of peripheral nerve anatomy and function as it relates to relevant arterial access sites to avoid injury.
尽管血管造影和血管内介入治疗引起的周围神经损伤并不常见，且通常不会造成永久性损伤，但可能会导致严重的功能障碍。大多数用于血管造影和血管内治疗的动脉都与神经非常接近。神经可能会因穿刺针穿刺、血肿、假性动脉瘤、止血装置的压迫，或者用手压迫而受到损伤。在文献报道中，股动脉入路的发生率低至大回顾性研究中的 0.04%，而肱动脉和腋窝入路的发生率高达 9%。鉴于血管内动脉介入操作的频率越来越高，以及非传统入路的使用越来越多，介入医生了解与相关动脉入路相关的周围神经解剖和功能非常重要，以避免损伤。
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