Shinozaki Norihiko, Ikari Yuji
Department of Cardiology, Asama General Hospital, 1862-1 Iwamurada, Saku, Nagano, Japan.
Department of Cardiology, Tokai University School of Medicine, Isehara, Japan.
Cardiovasc Interv Ther. 2022 Jul;37(3):533-537. doi: 10.1007/s12928-021-00801-7. Epub 2021 Aug 18.
It has been reported that the distal transradial approach (dTRA) is safe and useful for percutaneous coronary intervention (PCI). In this study we evaluated the safety and efficacy of the dTRA for endovascular therapy (EVT). The dTRA for EVT was performed in 43 lesions from 35 patients. Approach site was determined at the discretion of the operator. Clinical data were analyzed retrospectively. Average patient age was 74.0 ± 6.5 years; 30 (86%) were male; average height was 161.1 ± 8.4 cm. Diabetes mellitus, hypertension, dyslipidemia, and smoking habit were present in 19 (54.3%), 31 (88.6%), 29 (82.9%), and 29 (82.9%) patients, respectively. Target lesions were iliac artery in 38 (88.4%) patients, superficial femoral artery in 4 (9.3%) and renal artery in the remaining patient (2.3%). Eight lesions (18.6%) were chronic total occlusions. Thirteen (30.2%), 2 (4.7%), and 28 (65.1%) lesions were treated using 4.5, 6, and 7 French long guiding systems, respectively. All lesions were successfully treated without any procedural or access site-related complications. No additional puncture sites were required. Ankle brachial index significantly improved from 0.62 ± 0.20 to 0.92 ± 0.17 (p < 0.0001) post-treatment for the lower limbs. There were no radial artery occlusions, target lesion revascularization, or complications 1 month later. Similar to PCI, the dTRA for EVT is safe and feasible without any specific complications in carefully selected patients.
据报道，经桡动脉远端入路（dTRA）用于经皮冠状动脉介入治疗（PCI）是安全且有效的。在本研究中，我们评估了dTRA用于血管内治疗（EVT）的安全性和有效性。对35例患者的43处病变进行了EVT的dTRA操作。入路部位由操作者自行决定。对临床数据进行回顾性分析。患者平均年龄为74.0±6.5岁；男性30例（86%）；平均身高为161.1±8.4厘米。分别有19例（54.3%）、31例（88.6%）、29例（82.9%）和29例（82.9%）患者患有糖尿病、高血压、血脂异常和有吸烟习惯。38例（88.4%）患者的靶病变位于髂动脉，4例（9.3%）位于股浅动脉，其余1例患者（2.3%）位于肾动脉。8处病变（18.6%）为慢性完全闭塞病变。分别使用4.5、6和7法国长的导引导管系统对13处（30.2%）、2处（4.7%）和28处（65.1%）病变进行了治疗。所有病变均成功治疗，无任何手术或入路部位相关并发症。无需额外的穿刺部位。下肢治疗后踝肱指数从0.62±0.20显著提高至0.92±0.17（p<0.0001）。1个月后无桡动脉闭塞、靶病变血运重建或并发症发生。与PCI相似，在精心挑选的患者中，用于EVT的dTRA是安全可行的，无任何特殊并发症。
