Khanna Omaditya, Velagapudi Lohit, Das Somnath, Sweid Ahmad, Mouchtouris Nikolaos, Al Saiegh Fadi, Avery Michael B, Chalouhi Nohra, Schmidt Richard F, Sajja Kalyan, Gooch M Reid, Tjoumakaris Stavropoula, Rosenwasser Robert H, Jabbour Pascal M
J Neurosurg. 2020 Nov 13;135(3):727-732. doi: 10.3171/2020.7.JNS201174. Print 2021 Sep 1.
In this study, the authors aimed to investigate procedural and clinical outcomes between radial and femoral artery access in patients undergoing thrombectomy for acute stroke.
The authors conducted a single-institution retrospective analysis of 104 patients who underwent mechanical thrombectomy, 52 via transradial access and 52 via traditional transfemoral access. They analyzed various procedural and clinical metrics between the two patient cohorts.
There was no difference between patient demographics or presenting symptoms of stroke severity between patients treated via transradial or transfemoral access. The mean procedural time was similar between the two treatment cohorts: 60.35 ± 36.81 minutes for the transradial group versus 65.50 ± 29.92 minutes for the transfemoral group (p = 0.451). The mean total fluoroscopy time for the procedure was similar between the two patient cohorts (20.31 ± 11.68 for radial vs 18.49 ± 11.78 minutes for femoral, p = 0.898). The majority of patients underwent thrombolysis in cerebral infarction score 2b/3 revascularization, regardless of access site (92.3% for radial vs 94.2% for femoral, p = 0.696). There was no significant difference in the incidence of access site or periprocedural complications between the transradial and transfemoral cohorts.
Acute stroke intervention performed via transradial access is feasible and effective, with no significant difference in procedural and clinical outcomes compared with traditional transfemoral access. Larger studies are required to further validate the efficacy and limitations of transradial access for neurointerventional procedures.
在本研究中，作者旨在调查急性卒中患者行取栓术时经桡动脉和股动脉入路的操作及临床结局。
作者对104例行机械取栓术的患者进行了单机构回顾性分析，其中52例经桡动脉入路，52例经传统股动脉入路。他们分析了两组患者之间的各种操作和临床指标。
经桡动脉或股动脉入路治疗的患者在人口统计学特征或卒中严重程度的表现症状方面没有差异。两个治疗组的平均操作时间相似：桡动脉组为60.35±36.81分钟，股动脉组为65.50±29.92分钟（p = 0.451）。两组患者手术的平均总透视时间相似（桡动脉组为20.31±11.68分钟，股动脉组为18.49±11.78分钟，p = 0.898）。无论入路部位如何，大多数患者的脑梗死溶栓评分在2b/3级血管再通（桡动脉组为92.3%，股动脉组为94.2%，p = 0.696）。桡动脉组和股动脉组在入路部位或围手术期并发症的发生率上没有显著差异。
经桡动脉入路进行急性卒中干预是可行且有效的，与传统股动脉入路相比，在操作和临床结局方面没有显著差异。需要更大规模的研究来进一步验证经桡动脉入路在神经介入手术中的疗效和局限性。
