Khalifeh Ali, Tolaymat Besher, Noggle Joseph, Kalsi Richa, Owen Christine, Nelms Justin
Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
Vascular Center, University of Maryland Baltimore Washington Medical Center, Glen Burnie, MD, USA.
Vasc Endovascular Surg. 2020 May;54(4):319-324. doi: 10.1177/1538574420906942. Epub 2020 Feb 21.
Radial artery access is widely utilized in coronary angiography with reported lower rates of vascular complications and better patient comfort. There is limited data in the literature regarding radial access in peripheral endovascular procedures. We hypothesize that radial access is safe and feasible for peripheral endovascular procedures.
A retrospective chart review was performed for all patients who underwent angiography using radial artery access between August 2013 and December 2017. Patient demographics and perioperative data were recorded and analyzed.
The operating surgeon screened patients presenting for elective angiography for possible radial artery access. Ultrasound guidance was used in all cases. Upon cannulation, the sheath was infused with an antispasmodic cocktail, and the patients were systemically anticoagulated.
Forty-seven out of 52 patients successfully completed their procedure (90% success rate). The patients were mostly female (60%), elderly (mean age of 71 years), and had several comorbidities. Preoperative diagnoses were variable. Procedures were both diagnostic (58%) and interventional (42%) with maximum sheath size used being 7F and median fluoroscopy time of 7.5 minutes. Only 2 patients experienced perioperative complications, and both of these were minor hematomas that resolved with manual pressure.
Transradial arterial access for peripheral vascular angiography and interventions is safe and feasible. With low complication rates and increased patient comfort, transradial access serves as an excellent alternative to transfemoral access for a variety of endovascular procedures.
桡动脉入路在冠状动脉造影中被广泛应用，据报道其血管并发症发生率较低，患者舒适度更高。关于外周血管腔内介入手术中桡动脉入路的文献资料有限。我们推测桡动脉入路在外周血管腔内介入手术中是安全可行的。
对2013年8月至2017年12月期间所有采用桡动脉入路进行血管造影的患者进行回顾性病历审查。记录并分析患者的人口统计学资料和围手术期数据。
手术医生对拟行择期血管造影的患者进行筛选，以确定是否可能采用桡动脉入路。所有病例均使用超声引导。插管时，向鞘管内注入抗痉挛混合液，并对患者进行全身抗凝。
52例患者中有47例成功完成手术（成功率90%）。患者大多为女性（60%），年龄较大（平均年龄71岁），且有多种合并症。术前诊断各不相同。手术包括诊断性（58%）和介入性（42%），使用的最大鞘管尺寸为7F，平均透视时间为7.5分钟。只有2例患者出现围手术期并发症，且均为小血肿，通过手动压迫得以解决。
外周血管造影和介入手术采用桡动脉入路是安全可行的。桡动脉入路并发症发生率低，患者舒适度提高，是多种血管腔内手术中股动脉入路的极佳替代方法。
