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[神经血管内介入手术中的经桡动脉入路]

[Transradial approach in neuroendovascular procedures].

作者信息

Babichev K N, Kandyba D V, Svistov D V, Martynov R S, Savello A V, Platonov S A

机构信息

Kirov Military Medical Academy, St. Petersburg, Russia.

Dzhanelidze St. Petersburg Research Institute for Emergency Care, St. Petersburg, Russia.

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2022;86(1):28-38. doi: 10.17116/neiro20228601128.

Abstract

OBJECTIVE

To evaluate safety and feasibility of transradial approach for neuroendovascular procedures and to familiarize neurosurgeons and neuroradiologists with the capabilities and limitations of this approach, as well as technical features influencing its effectiveness.

MATERIAL AND METHODS

A retrospective analysis was performed in 270 patients who underwent transradial neuroendovascular procedures between January 2015 and December 2019. Diagnostic and surgical interventions were performed in 203 (75.2%) and 67 (24.8%) patients, respectively. The authors comprehensively describe catheterization technique and choosing the instrument for effective and safe transradial access.

RESULTS

The right vertebral and both common carotid arteries were the most accessible for selective catheterization (100% of cases). The left common carotid artery was catheterized in all cases, the left internal carotid artery - only in 92% of cases. If catheterization of the left vertebral artery was necessary, we used the left-sided radial approach. Conversion to femoral approach was required in 2.6% of cases for the left internal carotid artery disease (=7). Radial artery occlusion occurred in 3.7% of cases (=10) and was asymptomatic in all cases. We present a video clip (https://youtu.be/3wZ6O8u-lpk) devoted to various surgical interventions through radial approach.

CONCLUSION

Radial approach is safe and feasible and may be used for neuroendovascular procedures.

摘要

目的

评估经桡动脉途径进行神经血管内介入手术的安全性和可行性,并使神经外科医生和神经放射科医生熟悉该途径的能力和局限性,以及影响其有效性的技术特点。

材料与方法

对2015年1月至2019年12月期间接受经桡动脉神经血管内介入手术的270例患者进行回顾性分析。分别对203例(75.2%)患者进行了诊断性干预,对67例(24.8%)患者进行了手术干预。作者全面描述了插管技术以及选择有效且安全的经桡动脉入路的器械。

结果

右椎动脉和双侧颈总动脉最易于进行选择性插管(100%的病例)。所有病例均成功插管至左颈总动脉,而左颈内动脉仅在92%的病例中成功插管。若有必要对左椎动脉进行插管,我们采用左侧桡动脉入路。对于左颈内动脉疾病(n = 7),2.6%的病例需要转为股动脉入路。3.7%的病例(n = 10)出现桡动脉闭塞,所有病例均无症状。我们提供了一个视频片段(https://youtu.be/3wZ6O8u-lpk),展示了通过桡动脉途径进行的各种手术干预。

结论

桡动脉途径安全可行,可用于神经血管内介入手术。

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