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经腕部桡动脉远侧入路在解剖鼻烟窝行内脏介入是一种安全可行的技术。

Distal radial artery access is a safe and feasible technique in the anatomical snuffbox for visceral intervention.

机构信息

Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

Medicine (Baltimore). 2023 Jun 16;102(24):e33987. doi: 10.1097/MD.0000000000033987.

Abstract

Regarding the site of arterial access during the intervention, transracial intervention can reduce the risk of bleeding and vessel-related complications as well as improve patient comfort. Importantly, the distal radial artery (DRA) approach may reduce the incidence of radial artery occlusion and digital ischemia, but the feasibility and safety of DRA in performing subdiaphragmatic vascular interventions remain unclear. From January 2018 to December 2019, 106 patients were admitted to our department for visceral angiography and intervention by left distal radial artery accessing in an anatomical snuffbox. In total, 152 times of vascular interventions were performed during this period. Patients demographics, procedure details, technical success, and access site-related complications were recorded and evaluated. The mean age was 58.9 (range 22-86) years. Males accounted for 80.2%. Thirty-five patients (33%) had 2 or more procedures via the DRA approach. Technical success was achieved for 96.1% of procedures (146 cases) and 3.9% of cases failed to perform the intended procedure via the DRA approach (6 cases). The 4-Fr sheath was used in 86.8% of cases, and the 5 Fr sheath was used in the rest of the 13.2% of procedures. The rate of asymptomatic radial artery occlusion was 5.7% (6 of 106 patients). No patient suffered from distal limb ischemia after a long-time follow-up. Eight patients suffered postoperative local pain, transient numbness, or local bruised in the anatomical snuffbox without major complications. Patients with postoperative complications recovered quickly by using nonsteroidal anti-inflammatory drugs or without further treatment. Left distal radial artery access is safe and feasible as a new technique for visceral angiography and intervention.

摘要

关于介入治疗中的动脉入路部位,经皮桡动脉入路可降低出血和血管相关并发症的风险,并提高患者舒适度。重要的是,远端桡动脉(DRA)入路可降低桡动脉闭塞和手指缺血的发生率,但 DRA 行膈下血管介入的可行性和安全性尚不清楚。2018 年 1 月至 2019 年 12 月,我院采用桡动脉入路行解剖学鼻烟窝内左侧远端桡动脉入路对 106 例患者行内脏血管造影和介入治疗。在此期间共进行了 152 次血管介入治疗。记录并评估了患者的一般资料、手术细节、技术成功率和入路相关并发症。患者的平均年龄为 58.9 岁(范围 22-86 岁)。男性占 80.2%。35 例(33%)患者通过 DRA 途径进行了 2 次或更多次操作。96.1%(146 例)的手术达到了技术成功,3.9%(6 例)的手术因 DRA 途径无法进行预期的手术而失败。86.8%的病例使用了 4Fr 鞘,其余 13.2%的病例使用了 5Fr 鞘。无症状桡动脉闭塞的发生率为 5.7%(106 例患者中有 6 例)。长期随访无患者发生远端肢体缺血。8 例患者术后出现局部疼痛、短暂麻木或解剖学鼻烟窝局部瘀伤,但无重大并发症。术后并发症患者使用非甾体抗炎药或无需进一步治疗后很快恢复。作为一种新的内脏血管造影和介入技术,左侧远端桡动脉入路是安全可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dac/10270534/a6578a97abf4/medi-102-e33987-g001.jpg

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