Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Diagn Interv Radiol. 2022 Jul;28(4):359-363. doi: 10.5152/dir.2022.201100.
PURPOSE We aimed to determine the safety and feasibility of transradial access (TRA) in bronchial artery and non-bronchial systemic artery (NBSA) embolization in patients with non-massive hemoptysis. METHODS This retrospective study was approved by the Institutional Review Board. Among the 300 patients treated for hemoptysis with bronchial artery and NBSA embolization between April 2018 and July 2019, 19 procedures in 19 patients were conducted by TRA and were retrospectively analyzed. TRA was considered when the bronchial artery or NBSA originated from the arch vessel or its tributaries. The exclusion criteria of TRA included Barbeau C or D waveform and a radial artery diameter of less than 1.8 mm on ultrasound. TRA was also avoided in cases of the high-origin bronchial artery (i.e., T4 or higher level of the aorta). The hemoptysis-free time was estimated using the Kaplan-Meier method. RESULTS The technical success (i.e., embolization of all target artery with TRA) rate was 94.7% (18 out of 19 patients). In terms of the target arteries, embolization with TRA was technically successful in treating 47 out of 48 arteries (97.9%). The 1-month and 6-month hemoptysis-free rates were 89.5% (17/19) and 73.7% (14/19), respectively. The only adverse event was iatrogenic dissection of the bronchial artery with little clinical significance in 1 patient. No access site complications were identified on post-procedure day 1 ultrasonography. CONCLUSION With proper patient selection, TRA offers a safe and effective approach to embolize the bronchial arteries and NBSAs in patients with hemoptysis.
目的 本研究旨在确定经桡动脉入路（TRA）在非大量咯血患者支气管动脉和非支气管系统性动脉（NBSA）栓塞中的安全性和可行性。
方法 本回顾性研究经机构审查委员会批准。在 2018 年 4 月至 2019 年 7 月期间，对 300 例咯血患者行支气管动脉和 NBSA 栓塞治疗，其中 19 例（19 例患者）采用 TRA，对这些患者进行回顾性分析。当支气管动脉或 NBSA 起源于弓状血管或其分支时，考虑采用 TRA。TRA 的排除标准包括 Barbeau C 或 D 波形以及超声检查时桡动脉直径小于 1.8mm。TRA 也避免用于高位支气管动脉（即 T4 或更高水平的主动脉）。采用 Kaplan-Meier 法估计无咯血时间。
结果 技术成功率（即通过 TRA 栓塞所有靶动脉）为 94.7%（19 例患者中的 18 例）。在靶动脉方面，TRA 技术成功栓塞了 48 条动脉中的 47 条（97.9%）。1 个月和 6 个月的无咯血率分别为 89.5%（19 例中的 17 例）和 73.7%（19 例中的 14 例）。唯一的不良事件是 1 例患者出现轻微临床意义的支气管动脉医源性夹层。术后第 1 天超声检查未发现穿刺部位并发症。
结论 在适当的患者选择下，TRA 为咯血患者的支气管动脉和 NBSA 栓塞提供了一种安全有效的方法。
