Shinozaki Norihiko, Iwasaki Yusuke, Doi Hideki, Imoto Yuki, Ikari Yuji
Department of Cardiology, Asama General Hospital, 1862-1 Iwamurada, Saku, Nagano, Japan.
Department of Cardiology, Tokai University School of Medicine, Isehara, Japan.
Cardiovasc Interv Ther. 2025 Jan;40(1):89-94. doi: 10.1007/s12928-024-01026-0. Epub 2024 Jul 16.
Large-scale multicenter studies demonstrating the safety and effectiveness of transradial iliac artery stenting are lacking. We evaluated the data from a multicenter database in Japan. Transradial iliac artery stenting was performed on 115 lesions in 105 patients. The approach site was determined at the discretion of the operator. Patients with scheduled multiple sheath insertions for the bidirectional approach were excluded. Clinical data were retrospectively analyzed. The average age of this cohort was 71.1 ± 8.3 years. Eighty-six patients (81.9%) were male. Diabetes mellitus, hypertension, dyslipidemia, and smoking habit were present in 39 (37.1%), 84 (80.0%), 69 (65.7%), and 78 patients (74.3%), respectively. Rutherford classifications 1, 2, 3, 4, and 5 comprised 40 (34.8%), 42 (36.5%), 28 (24.3%), 3 (2.6%), and 2 (1.7%) lesions, respectively, while Trans-Atlantic Inter-Society Consensus II classifications A, B, C, and D comprised 74 (64.3%), 21 (18.3%), 15 (13.0%), and 5 (4.3%), respectively. Twenty-seven lesions (23.5%) had chronic total occlusion. All lesions were successfully treated with 141 stents. Four patients (3.8%) required additional puncture of the common femoral artery for successful stent implantation. The ankle-brachial index significantly improved from 0.65 ± 0.17 to 0.95 ± 0.15 (P < 0.0001). None of the patients experienced any procedural or access site-related complications. Asymptomatic radial artery occlusion was observed in three cases (2.9%) after the procedure. There were no target lesion revascularizations or complications at 1 month. Compared to the traditional transfemoral approach, transradial iliac artery stenting is safe and feasible without any specific complications in carefully selected patients.
目前缺乏大规模多中心研究来证明经桡动脉髂动脉支架置入术的安全性和有效性。我们评估了来自日本一个多中心数据库的数据。对105例患者的115处病变进行了经桡动脉髂动脉支架置入术。入路部位由操作者自行决定。计划进行双向入路多次鞘管置入的患者被排除。对临床数据进行了回顾性分析。该队列患者的平均年龄为71.1±8.3岁。86例患者（81.9%）为男性。糖尿病、高血压、血脂异常和吸烟习惯分别存在于39例（37.1%）、84例（80.0%）、69例（65.7%）和78例患者（74.3%）中。卢瑟福分级1、2、3、4和5分别包括40处（34.8%）、42处（36.5%）、28处（24.3%）、3处（2.6%）和2处（1.7%）病变，而跨大西洋跨学会共识II分级A、B、C和D分别包括74处（64.3%）、21处（18.3%）、15处（13.0%）和5处（4.3%）病变。27处病变（23.5%）存在慢性完全闭塞。所有病变均成功置入141枚支架。4例患者（3.8%）为成功植入支架需要额外穿刺股总动脉。踝肱指数从0.65±0.17显著提高到0.95±0.15（P<0.0001）。所有患者均未出现任何手术或入路部位相关并发症。术后3例患者（2.9%）出现无症状桡动脉闭塞。1个月时无靶病变血管重建或并发症发生。与传统经股动脉入路相比，经桡动脉髂动脉支架置入术在精心挑选的患者中是安全可行的，且无任何特定并发症。
