Department of Neurology, Nantong Third People's Hospital, Nantong, China.
Department of Stroke Center, Affiliated Hospital of Nantong University, Nantong, China.
Neurol Res. 2023 Dec;45(12):1063-1068. doi: 10.1080/01616412.2023.2257410. Epub 2023 Nov 1.
Many large randomized trials in interventional cardiology have shown a significant advantage of transradial access (TRA) over transfemoral access (TFA). However, TRA has yet been widely used in Neurovascular interventional surgery. The purpose of this retrospective comparative study is to compare the effectiveness and safety of transradial and transfemoral accesses for cerebral angiography.
A total of 380 patients underwent cerebral angiography in our center between January 2019 and January 2021. Among them, 192 patients underwent TRA, and 188 patients via TFA. The success rate of cerebral angiography, X-ray time, total absorbed dose, dose-area product (DAP), complications, and other clinical data were extracted.
The operative success (94.27% vs 97.87%; = 0.071) and the puncture failure (1.56% vs 1.60%) were not significantly different between the TRA and TFA groups. Only arterial spasm, which is more common in the TRA group, was substantially different between the two groups in terms of surgical consequences ( = 0.015). In addition, there were no significant differences between the groups in total absorbed dose ( = 0.604) and DAP( = 0.097). However, the X-ray time of the TRA group [281.50(216.30,342.00)] was shorter than the TFA group [296.50(230.80,363.50)] ( = 0.019).
TRA is effective and safe in cerebral angiography, and its use may be expanded.
许多介入心脏病学的大型随机试验表明，经桡动脉入路（TRA）优于经股动脉入路（TFA）。然而，TRA 在神经血管介入手术中尚未广泛应用。本回顾性对比研究的目的是比较经桡动脉和经股动脉入路行脑血管造影的有效性和安全性。
本研究共纳入 2019 年 1 月至 2021 年 1 月在我院行脑血管造影的 380 例患者。其中 192 例行 TRA，188 例行 TFA。提取脑血管造影成功率、X 线时间、总吸收剂量、剂量面积乘积（DAP）、并发症等临床资料。
TRA 组和 TFA 组的手术成功率（94.27%比 97.87%； = 0.071）和穿刺失败率（1.56%比 1.60%）差异无统计学意义。TRA 组仅动脉痉挛的手术后果明显不同于 TFA 组（ = 0.015）。此外，两组的总吸收剂量（ = 0.604）和 DAP（ = 0.097）差异无统计学意义。然而，TRA 组的 X 线时间[281.50（216.30，342.00）]短于 TFA 组[296.50（230.80，363.50）]（ = 0.019）。
TRA 在脑血管造影中是有效且安全的，其应用可能会扩大。
