Department of Neurosurgery, University of Tokyo Hospital, Tokyo 113-8655, Japan.
Interv Neuroradiol. 2024 Apr;30(2):280-287. doi: 10.1177/15910199221135308. Epub 2022 Oct 26.
The transradial artery approach to cerebral angiography can reduce both patient stress following examination and the risk of major complications due to hematoma. Recently, the distal radial artery approach (DRA) has garnered attention in cardiology as a minimally invasive method. DRA is also considered applicable to neurosurgery, although concerns about procedural difficulty and complications persist. Therefore, this study aimed to evaluate the efficacy of the DRA in cerebral angiography and neuroendovascular treatment.
We retrospectively selected 30 consecutive patients for whom the DRA was attempted for cerebral angiography at our hospital. The patients' age, sex, height, weight, and medical history information was collected and correlated with successful puncture and complications. The diameter of the distal radial artery (RA) was measured using ultrasonography.
The median patient age was 67 years (range, 32-87 years) and 21 (70%) were men. The median diameter of the distal RA was 2.3 mm (range, 1.7-3.2 mm). Distal RA puncture was successful in 23 patients (77%) and no complications were noted; however there was no significant correlation between successful puncture and any of the patient factors. Carotid artery stenting and preoperative tumor embolization were performed via DRA in six and three cases, respectively. Although puncture site hematoma occurred in only one case, all treatments were successful, and no major complications were observed.
DRA can be safely used for cerebral angiography and neuroendovascular treatment.
经桡动脉入路行脑血管造影术可减少检查后的患者应激反应,降低因血肿导致的严重并发症风险。最近,经远端桡动脉入路(DRA)在心脏病学中作为一种微创方法引起了关注。DRA 也被认为适用于神经外科,尽管对手术难度和并发症仍存在担忧。因此,本研究旨在评估 DRA 在脑血管造影和神经血管内治疗中的疗效。
我们回顾性选择了 30 例连续患者,这些患者在我院尝试经 DRA 进行脑血管造影。收集了患者的年龄、性别、身高、体重和病史信息,并与成功穿刺和并发症相关联。使用超声测量远端桡动脉(RA)的直径。
患者中位年龄为 67 岁(范围 32-87 岁),21 例(70%)为男性。远端 RA 的中位直径为 2.3mm(范围 1.7-3.2mm)。23 例(77%)患者远端 RA 穿刺成功,无并发症;但成功穿刺与任何患者因素均无显著相关性。经 DRA 行颈动脉支架置入术和术前肿瘤栓塞术分别为 6 例和 3 例。虽然仅 1 例出现穿刺部位血肿,但所有治疗均成功,无严重并发症发生。
DRA 可安全用于脑血管造影和神经血管内治疗。