Hadjivassiliou Anastasia, Cardarelli-Leite Leandro, Jalal Sabeena, Chung John, Liu David, Ho Stephen, Klass Darren
Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC V5Z 1M9, Canada.
Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC V5Z 1M9, Canada.
J Vasc Interv Radiol. 2020 Aug;31(8):1328-1333. doi: 10.1016/j.jvir.2020.02.027. Epub 2020 Jul 4.
To assess safety and efficacy of a modified rapid hemostasis protocol for distal transradial access (TRA).
A single-center retrospective study of patients undergoing percutaneous image-guided procedures from a distal TRA with rapid deflation hemostasis protocol was performed. Between March 2017 and August 2019, 593 procedures in 434 patients were performed. Mean patient age was 63.5 y (range, 18-94 y).
The most common procedures were transarterial chemoembolization (218; 36.8%), abdominal and pelvic embolization (116; 19.6%), yttrium-90 mapping (115; 19.4%), yttrium-90 administration (84; 14.2%), and diagnostic angiography (44; 7.4%). Mean (range) values for clotting parameters were international normalized ratio 1.2 (0.9-3.2), partial thromboplastin time 33.5 s (26-44 s), and platelets 23.4 × 10/L (37-552 × 10/L). A hematoma developed in 7 (1.2%) patients. No radial artery occlusions were encountered during follow-up. Nursing intensity was defined as the number of minutes after the procedure required for assessing and managing the access site for bleeding. The mean nursing intensity was 25.1 min (range, 25-40 min).
The rapid deflation hemostasis protocol for distal TRA at the anatomical snuffbox was feasible and safe. No significant difference or association was found between hematoma formation and clotting parameters after the procedure or type of vascular access equipment used.
评估改良快速止血方案用于远端桡动脉入路（TRA）的安全性和有效性。
对采用快速放气止血方案经皮影像引导下进行远端TRA手术的患者进行单中心回顾性研究。2017年3月至2019年8月期间，对434例患者进行了593例手术。患者平均年龄为63.5岁（范围18 - 94岁）。
最常见的手术是经动脉化疗栓塞（218例；36.8%）、腹部和盆腔栓塞（116例；19.6%）、钇-90定位（115例；19.4%）、钇-90给药（84例；14.2%）以及诊断性血管造影（44例；7.4%）。凝血参数的均值（范围）为国际标准化比值1.2（0.9 - 3.2）、活化部分凝血活酶时间33.5秒（26 - 44秒）以及血小板23.4×10⁹/L（37 - 552×10⁹/L）。7例（1.2%）患者出现血肿。随访期间未发现桡动脉闭塞。护理强度定义为术后评估和处理穿刺部位出血所需的分钟数。平均护理强度为25.1分钟（范围25 - 40分钟）。
在解剖鼻烟窝处采用快速放气止血方案进行远端TRA是可行且安全的。术后血肿形成与凝血参数或所使用血管通路设备类型之间未发现显著差异或关联。
