Department of Radiology, 28068Universidad de Valparaíso, Chile.
Complex Imaging Unit, 60701Hospital Carlos Van Buren, Chile.
Interv Neuroradiol. 2022 Aug;28(4):381-385. doi: 10.1177/15910199211041868. Epub 2021 Sep 13.
Transradial access is widely used in cardiological adult interventions and less in pediatrics. In recent years, this access has become more popular in the neuroradiological community in adult patients since it has fewer complications and is more comfortable for the patient after the procedure. We present a single-center case series of 52 transradial access neurointerventions (43 angiographies and 9 therapeutic procedures) in pediatric patients, with a failure of 4 cases (7.7%) in which we could not puncture the artery, crossing over to transfemoral access. Since in five cases we did angiography followed by therapeutic intervention, thus doing only one puncture access for both procedures, then our access failure rate was 10.6%. The 34 successful transradial access solely angiographies had a median radiation exposure of 887 mGy (interquartile range 628-1352), median fluoroscopy time of 9.5 min (interquartile range 7.5-15.3), and median procedure time of 28 min (interquartile range 24-33 min) Therapeutic procedure diagnosis were: one ruptured saccular aneurysm, two juvenile nasopharyngeal angiofibromas, and five arteriovenous malformations. The transradial access neurointerventions for pediatric population older than 11 years is safe and feasible, having previous experience in adults. Younger population should be considered on a case-to-case basis, depending on ultrasound measurement of the arterial diameter and the materials available.
经桡动脉入路在心血管成人介入中广泛应用,而在儿科中应用较少。近年来,由于经桡动脉入路并发症较少,且患者术后舒适度较高,因此在成人神经放射学领域越来越受欢迎。我们报告了 52 例儿科患者经桡动脉入路神经介入(43 例血管造影和 9 例治疗性操作)的单中心病例系列,其中 4 例(7.7%)因无法穿刺动脉而转为经股动脉入路。由于有 5 例患者先进行血管造影,然后进行治疗性干预,因此只进行一次穿刺入路即可完成两种操作,因此我们的入路失败率为 10.6%。34 例成功的单纯经桡动脉入路血管造影的中位数辐射暴露量为 887 mGy(四分位距 628-1352),中位数透视时间为 9.5 分钟(四分位距 7.5-15.3),中位数操作时间为 28 分钟(四分位距 24-33 分钟)。治疗性操作诊断包括:1 例破裂的囊状动脉瘤、2 例青少年鼻咽血管纤维瘤和 5 例动静脉畸形。对于 11 岁以上的儿科人群,经桡动脉入路神经介入是安全可行的,在成人中已有相关经验。对于年龄较小的患者,应根据动脉直径的超声测量和可用的材料,具体情况具体考虑。