Chen Shang-Xiong, Zhang Bin, Hao Ying-Xue, Xiao Hang
Department of Vascular Surgery, Southwest Hospital, Army Medical University, Chongqing, China.
Angiology. 2024 Jul;75(6):556-564. doi: 10.1177/00033197231163358. Epub 2023 Mar 15.
This study compared the efficacy and safety of distal transradial access (dTRA) and common femoral artery access (CFA) for endovascular treatment of non-coronary arterial disease. 102 interventions were divided into dTRA ( = 51) and CFA ( = 51) groups; the puncture success rate was 100% in both groups. The mean number of punctures and puncture time were greater in the dTRA than CFA group (1.86 vs 1.04 and 3.96 vs ≤1.00 min, < .001 for both), whereas the access-related complication rate was comparable. The surgical success rate was higher in the CFA than dTRA group (98.0 vs 84.3, = .036), and the operative time was longer in the dTRA than CFA group (99.09 vs 84.10 min, = .017). The postoperative adverse event rate was not different between the dTRA and CFA groups. dTRA is a safe and feasible access for non-coronary arterial disease and is comparable to CFA in terms of puncture success, access-related complications, and major adverse events. The dTRA is inferior to CFA in the treatment of lower extremity arterial disease. Due to the increase in the operation time and the contrast medium volume in the dTRA, it is necessary to be vigilant about contrast nephropathy and late radiological random side effects.
本研究比较了经桡动脉远端入路(dTRA)和股总动脉入路(CFA)用于非冠状动脉疾病血管内治疗的疗效和安全性。102例介入治疗被分为dTRA组(n = 51)和CFA组(n = 51);两组的穿刺成功率均为100%。dTRA组的平均穿刺次数和穿刺时间均多于CFA组(分别为1.86次对1.04次和3.96分钟对≤1.00分钟,两者P均<0.001),而与入路相关的并发症发生率相当。CFA组的手术成功率高于dTRA组(98.0%对84.3%,P = 0.036),dTRA组的手术时间长于CFA组(99.09分钟对84.10分钟,P = 0.017)。dTRA组和CFA组术后不良事件发生率无差异。dTRA是用于非冠状动脉疾病的一种安全可行的入路,在穿刺成功率、与入路相关的并发症及主要不良事件方面与CFA相当。在下肢动脉疾病治疗中,dTRA不如CFA。由于dTRA手术时间和造影剂用量增加,有必要警惕造影剂肾病和晚期影像学随机副作用。