Roberts Jonathan S, Niu Jianli
Memorial Cardiac and Vascular Institute, Memorial Regional Hospital, 1150 N 35th Avenue, Suite 605, Hollywood, FL 33021 USA.
J Invasive Cardiol. 2023 Mar;35(3):E143-E150. doi: 10.25270/jic/22.00327. Epub 2023 Jan 26.
Palpation-guided access of the radial artery (RA) has transradial access (TRA) failure rates averaging 6%-7%. This study aimed to measure RA and ulnar artery (UA) diameters by ultrasound in a typical American population, in hopes of elucidating data that may improve TRA success rates.
Intraprocedural ultrasound measurements of the RA and UA in 565 consecutive patients undergoing TRA were retrospectively analyzed.
The RA is usually larger than the UA, with diameters of 3.0 mm and 2.7 mm, respectively. The UA was larger than the RA in 23% of the population studied, being larger than the RA by ≥20% in 6.5%. Men have larger RAs and UAs than women, with RA/UA diameters of 3.2/2.7 mm and 2.8/2.4 mm, respectively. Body mass index did not correlate with RA diameter. An RA to sheath ratio of <1.0 would have occurred in 6% of men and 16% of women with the use of a 6-Fr slender sheath. The distal RA was 0.5 mm (16%) smaller in diameter than the RA.
The RA is usually larger than the UA and will be the artery of choice for access in most patients. The UA was larger than the RA by ≥20% in 6.5% of patients studied, possibly making it the wrist artery of choice for access in many of these patients. No clinical variables predict RA or UA diameters. Ultrasound may improve TRA success rates by allowing accurate sizing of the RA/UA, thereby preventing inadvertent sheath oversizing causing radial artery spasm and TRA failure.
触诊引导下的桡动脉穿刺，经桡动脉入路（TRA）失败率平均为6%-7%。本研究旨在通过超声测量典型美国人群的桡动脉（RA）和尺动脉（UA）直径，以期阐明可能提高TRA成功率的数据。
对565例连续接受TRA的患者术中超声测量RA和UA的情况进行回顾性分析。
RA通常比UA大，直径分别为3.0毫米和2.7毫米。在所研究人群中，23%的患者UA大于RA，6.5%的患者UA比RA大≥20%。男性的RA和UA比女性大，RA/UA直径分别为3.2/2.7毫米和2.8/2.4毫米。体重指数与RA直径无关。使用6F细鞘时，6%的男性和16%的女性会出现RA与鞘管比例<1.0的情况。RA远端直径比RA小0.5毫米（16%）。
RA通常比UA大，在大多数患者中是穿刺的首选动脉。在所研究患者中，6.5%的患者UA比RA大≥20%，这可能使UA成为这些患者中许多人手腕穿刺的首选动脉。没有临床变量可预测RA或UA直径。超声可通过准确测量RA/UA大小来提高TRA成功率，从而防止鞘管意外过大导致桡动脉痉挛和TRA失败。
