From the Divisions of Neuroradiology and Image-Guided Therapy (H.A., A.A.D., S.B., V.R., N.S., P.M.), Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Medical Imaging (K.B.), Children's Hospital at Westmead, Westmead, New South Wales, Australia.
AJNR Am J Neuroradiol. 2021 Aug;42(8):1492-1496. doi: 10.3174/ajnr.A7142. Epub 2021 May 6.
The feasibility and safety of transradial angiography is not established outside the adult literature. The objective of this study was to assess the feasibility and safety of transradial access for neuroangiography in adolescents.
A retrospective case-control study was performed, comparing transradial neuroendovascular procedures in adolescents (age range, 10-18 years) with an age- and procedure-matched cohort of transfemoral neuroendovascular procedures. Clinical and procedural details, including type of procedure, conversion rate, fluoroscopy time, radiation dose, complications, and readmissions, were reported by descriptive statistics or measures of central tendency and compared using a test or nonparametric equivalent. A value < .05 was considered statistically significant.
Twenty adolescents (mean age, 14.6 [SD, 1.7] years, M/F ratio = 9:11) who underwent transradial neuroangiography were compared against 20 adolescents (mean age, 14.4 [SD, 2.1 ] years, M/F ratio = 12:8) who underwent transfemoral neuroangiography. We found no significant difference in procedural success (0% conversion rate), fluoroscopy times (33.7 [SD, 40.2] minutes versus 23.3 [SD, 26.2] minutes, = .34) and radiation dose (150.9 [SD, 133.7] Gy×cm and 122.9 [SD, 79.7] Gy×cm, = .43) There were 2 self-limiting postprocedural complications in the transradial group. There were no major hemorrhages, need for further interventions, or readmissions in either group.
The benefits of transradial angiography described for adults can likely be safely extended to adolescents. These are important data before transitioning to smaller children and should be prospectively evaluated in a larger cohort.
经桡动脉入路行血管造影术的可行性和安全性尚未在成人文献中得到证实。本研究的目的是评估青少年经桡动脉入路行神经血管造影的可行性和安全性。
本研究回顾性地比较了青少年（年龄 10-18 岁）经桡动脉神经介入治疗和年龄及手术相匹配的经股动脉神经介入治疗的病例。报告了临床和手术细节，包括手术类型、转化率、透视时间、辐射剂量、并发症和再入院情况，通过描述性统计或集中趋势的度量进行报告，并使用 检验或非参数等效方法进行比较。 值<0.05 被认为具有统计学意义。
20 例青少年（平均年龄 14.6 [标准差 1.7] 岁，男女比例 9:11）接受经桡动脉神经血管造影术，与 20 例青少年（平均年龄 14.4 [标准差 2.1] 岁，男女比例 12:8）接受经股动脉神经血管造影术进行比较。我们发现手术成功率（无转化率）、透视时间（33.7 [标准差 40.2] 分钟与 23.3 [标准差 26.2] 分钟， =.34）和辐射剂量（150.9 [标准差 133.7] Gy×cm 与 122.9 [标准差 79.7] Gy×cm， =.43）无显著差异。经桡动脉组有 2 例自限性术后并发症。两组均无大出血、需要进一步干预或再入院。
经桡动脉入路行血管造影术的优势在成人中得到证实，并且可能在青少年中安全应用。这些是在向更小的儿童过渡之前的重要数据，应该在更大的队列中进行前瞻性评估。
