Alehaideb Ahmad, Ha Winston, Bickford Suzanne, Dmytriw Adam A, Bhatia Kartik, Amirabadi Afsaneh, Mohanta Arun, Chavhan Govind, Muthusami Prakash
Department of Image Guided Therapy (A.A., W.H., S.B., A.A.D., K.B., P.M.), The Hospital for Sick Children, University of Toronto, ON, Canada.
Department of Diagnostic Imaging (S.B., A.A.D., A.A., A.M., G.C., P.M.), The Hospital for Sick Children, University of Toronto, ON, Canada.
Circ Cardiovasc Interv. 2020 Jul;13(7):e009251. doi: 10.1161/CIRCINTERVENTIONS.120.009251. Epub 2020 Jul 2.
Transradial intervention is increasingly replacing approaches, due to lower access complications, cost, and improved patient satisfaction. There are limited supporting data in the pediatric literature, largely due to concerns regarding arterial size. The objective of this study was to measure radial artery diameters in children across all age groups, to establish reference ranges for clinical use.
This prospective study was carried out in children ≤18 years of age who underwent ultrasound for measuring radial artery diameters from November 2018 to November 2019. The cohort was divided into age groups: ≤2, 3 to 5, 6 to 8, 9 to 11, 12 to 14, 15 to 18 years, and into pre- and post-adolescent (≥12 years) groups.
One hundred thirty-four children (M:F=63:71) were included, with bilateral measurements resulting in 268 data points. Mean age was 8.9±5.8 years (range, 29 days to 18 years), mean weight 37.2±27.5 kg (range, 1.7-149.1 kg). Mean-corrected radial artery diameter was 1.86±0.44 mm. There was no difference in arterial diameters between males and females (1.90±0.50 versus 1.81±0.53 mm; =0.73) or between right and left sides (1.87±0.46 versus 1.87±0.47, =0.98). There was a strong correlation of diameter with age (R=0.75; <0.00001) and weight (R=0.74; <0.00001). There was linear increase in arterial growth rates in early childhood, followed by plateauing to adult sizes in adolescents. Inter-reader agreement was 0.95.
We provide a reference range for radial artery diameters across childhood ages, which can be used for decision-making. This could be the basis for designing a trial of transradial intervention in children, to establish clinical safety and efficacy.
由于穿刺部位并发症更少、成本更低且患者满意度更高，经桡动脉介入治疗正越来越多地取代其他治疗方法。儿科文献中的支持数据有限，主要是因为担心动脉尺寸问题。本研究的目的是测量各年龄组儿童的桡动脉直径，以建立可供临床使用的参考范围。
这项前瞻性研究针对2018年11月至2019年11月期间接受超声检查以测量桡动脉直径的18岁及以下儿童进行。队列被分为不同年龄组：≤2岁、3至5岁、6至8岁、9至11岁、12至14岁、15至18岁，以及青春期前和青春期后（≥12岁）组。
共纳入134名儿童（男:女 = 63:71），双侧测量产生268个数据点。平均年龄为8.9±5.8岁（范围：29天至18岁），平均体重37.2±27.5千克（范围：1.7 - 149.1千克）。平均校正桡动脉直径为1.86±0.44毫米。男性和女性之间的动脉直径无差异（1.90±0.50对1.81±0.53毫米；P = 0.73），左右两侧之间也无差异（1.87±0.46对1.87±0.47，P = 0.98）。直径与年龄（R = 0.75；P < 0.00001）和体重（R = 0.74；P < 0.00001）有很强的相关性。儿童早期动脉生长速率呈线性增加，随后在青少年期趋于平稳至成人尺寸。阅片者间一致性为0.95。
我们提供了各儿童年龄组桡动脉直径的参考范围，可用于决策。这可为设计儿童经桡动脉介入治疗试验以确定临床安全性和有效性奠定基础。
