Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Department of Neurosurgery and Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2021 Mar;147:e351-e353. doi: 10.1016/j.wneu.2020.12.054. Epub 2020 Dec 17.
Transradial access has been used increasingly for diagnostic cerebral angiography and neurointerventions. This requires development of a new skillset. Forming the Simmons catheter to catheterize the cerebral vessels is the most fundamental. Patient anatomy can complicate the formation of the Simmons catheter and the success of the procedure. The aim of this paper is to identify and describe the techniques that can be used transradially to facilitate the formation of the Simmons catheter for catheterization of the cerebral vessels.
We reviewed our series of 85 cerebral angiograms performed via a transradial approach at our institution between 2018 and 2019. We identified the techniques employed to form the Simmons catheter and compiled operative videos demonstrating each technique and its nuances.
We have identified 7 techniques used to form the Simmons catheter from a right radial approach: in the ascending aorta, in the descending aorta, in the aortic arch, by deflecting the catheter off of the aortic valve with the glidewire in the common carotid artery, by deflecting the catheter off of the aortic valve with the glidewire in the descending aorta, and directly in the right or left common carotid arteries. We have identified that formation of the Simmons catheter from a left radial approach is most easily done in the descending aorta.
Transradial artery access has become increasingly common in cerebral angiography and neurointerventions. We describe techniques used for the formation of the Simmons catheter, a fundamental skill necessary for transradial cerebral angiogram or neurointervention.
经桡动脉入路已越来越多地用于诊断性脑血管造影和神经介入。这需要发展新的技能。将 Simmons 导管成形以对脑血管进行导管插入是最基本的操作。患者的解剖结构可能会使 Simmons 导管的成形和手术的成功变得复杂。本文的目的是确定并描述可经桡动脉入路使用的技术，以方便形成 Simmons 导管以对脑血管进行导管插入。
我们回顾了我们机构在 2018 年至 2019 年间进行的 85 例经桡动脉入路脑血管造影术的系列研究。我们确定了形成 Simmons 导管所采用的技术，并编译了演示每种技术及其细微差别的手术视频。
我们已经确定了从右侧桡动脉入路形成 Simmons 导管的 7 种技术：在升主动脉、降主动脉、主动脉弓中，用滑丝将导管从主动脉瓣上向颈总动脉中偏转，用滑丝将导管从主动脉瓣上向降主动脉中偏转，以及直接在右或左颈总动脉中。我们发现，从左侧桡动脉入路形成 Simmons 导管最容易在降主动脉中完成。
经桡动脉入路在脑血管造影和神经介入中已越来越普遍。我们描述了形成 Simmons 导管的技术，这是经桡动脉脑血管造影或神经介入所必需的基本技能。
