Chen Tao, Li Lamei, Yang Anni, Huang Hui, Shi Ganwei, Li Feng, Li Wenhua, Lu Wei, Xu Lingxia, Li Li, Cai Gaojun
Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, the Wujin Clinical College of Xuzhou Medical University, Changzhou City, China.
Department of Cardiology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin City, China.
J Endovasc Ther. 2023 Oct 31:15266028231208638. doi: 10.1177/15266028231208638.
One of the important advantages of the distal transradial access (dTRA) is the significant reduction in the incidence of radial artery occlusion (RAO). There are few reports on the influencing factors for distal radial artery occlusion (dRAO) after cardiovascular interventions via the dTRA.
This retrospective analysis included the clinical data of patients who underwent a cardiovascular intervention via the dTRA. The dRAO was evaluated by ultrasound within 24 hours after the procedure. Multivariate logistic analysis was used to explore the influencing factors for dRAO.
The incidence of dRAO was 3.5% (28/805) at 24 hours follow-up after the procedure. In the comparison between the 2 groups, the preoperative distal radial artery (DRA) internal diameter in the dRAO group was significantly smaller than that in the non-dRAO group (p=0.001). The prevalence of DRA inner diameter/sheath outer diameter <1 was significantly higher in the dRAO group than in the non-dRAO group (p=0.013). The number of puncture attempts was significantly greater in the dRAO group than in the non-dRAO group (p=0.007). Multivariate logistic analysis showed that DRA inner diameter/sheath outer diameter <1 was an independent risk factor for dRAO (OR=4.827, 95% CI=1.087-21.441, p=0.039).
The incidence of dRAO 24 hours after cardiovascular intervention via the dTRA was 3.5%, and a DRA inner diameter/sheath outer diameter <1 was an independent risk factor for dRAO. Preoperative ultrasound assessment of vessel inner diameter and selection of a sheath with a smaller outer diameter may reduce the risk of dRAO.
The incidence of distal radial artery occlusion after cardiovascular intervention was 3.5%. The distal radial artery inner diameter/sheath outer diameter <1 was an independent risk factor for distal radial artery occlusion. Preoperative ultrasound assessment of vessel inner diameter and selection of a sheath with a smaller outer diameter may reduce the risk of distal radial artery occlusion. The number of puncture attempts and compression time were not related to distal radial artery occlusion.
桡动脉远端入路（dTRA）的重要优势之一是桡动脉闭塞（RAO）发生率显著降低。关于经dTRA进行心血管介入治疗后桡动脉远端闭塞（dRAO）的影响因素报道较少。
本回顾性分析纳入了经dTRA进行心血管介入治疗的患者的临床资料。术后24小时内通过超声评估dRAO情况。采用多因素逻辑回归分析探讨dRAO的影响因素。
术后24小时随访时，dRAO发生率为3.5%（28/805）。两组比较，dRAO组术前桡动脉远端（DRA）内径显著小于非dRAO组（p=0.001）。dRAO组DRA内径/鞘管外径<1的比例显著高于非dRAO组（p=0.013）。dRAO组穿刺尝试次数显著多于非dRAO组（p=0.007）。多因素逻辑回归分析显示，DRA内径/鞘管外径<1是dRAO的独立危险因素（OR=4.827，95%CI=1.087-21.441，p=0.039）。
经dTRA进行心血管介入治疗后24小时dRAO发生率为3.5%，DRA内径/鞘管外径<1是dRAO的独立危险因素。术前超声评估血管内径并选择外径较小的鞘管可能降低dRAO风险。
心血管介入治疗后桡动脉远端闭塞发生率为3.5%。桡动脉远端内径/鞘管外径<1是桡动脉远端闭塞的独立危险因素。术前超声评估血管内径并选择外径较小的鞘管可能降低桡动脉远端闭塞风险。穿刺尝试次数和压迫时间与桡动脉远端闭塞无关。
