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经股动脉和桡动脉路径数字减影血管造影临床价值的比较研究

Comparative study of the clinical value of digital subtraction angiography via femoral and radial arterial paths.

作者信息

Zeng Hu, Xie Jia-Yu, Xu Li-Xin, Cao Wu-Yang, Liu Meng-Jiao, Que Si-Wei

机构信息

Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South University Changde 415000, Hunan, China.

Gu Lian Rehabilitation Hospital of Changde City Changde 415000, Hunan, China.

出版信息

Am J Transl Res. 2024 Jul 15;16(7):3064-3071. doi: 10.62347/UBEV9768. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the clinical efficacy of digital subtraction angiography (DSA) performed via femoral artery and radial artery approaches.

METHODS

This retrospective study included 480 patients requiring cerebral vascular angiography at the First People's Hospital of Changde City from March 2020 to February 2022. Patients were divided into the femoral artery group (transfemoral approach, n=400) and the radial artery group (transradial approach, n=80) according to the surgical route. We compared perioperative metrics, success rates of selective angiography and puncture, and complication rates (including pseudoaneurysm, urinary retention, hematoma, vasospasm) between the groups. Multivariate logistic regression was used to analyze factors influencing the failure of angiography by each approach.

RESULTS

The radial artery group exhibited shorter durations for puncture, hemostasis, exposure, operation, and postoperative recovery (all P<0.001). The success rate of selective angiography was higher in the radial artery group (93.75%) compared to the femoral artery group (85.25%) (χ=4.168, P=0.041). No significant difference was found in puncture success rates between the groups (χ=0.235, P=0.628). The overall complication rate was significantly lower in the radial artery group (2.50%) compared to the femoral artery group (9.25%) (χ=4.069, P=0.044). Gender and low-density lipoprotein cholesterol levels were significant predictors of angiography failure in both approaches (both P<0.05).

CONCLUSION

The transradial approach for DSA is safe and feasible, offering advantages in terms of operational time and complication rates, making it the preferred method in clinical settings.

摘要

目的

评估经股动脉和桡动脉途径进行数字减影血管造影(DSA)的临床疗效。

方法

本回顾性研究纳入了2020年3月至2022年2月在常德市第一人民医院需要进行脑血管造影的480例患者。根据手术途径将患者分为股动脉组(经股动脉途径,n = 400)和桡动脉组(经桡动脉途径,n = 80)。我们比较了两组的围手术期指标、选择性血管造影成功率和穿刺成功率以及并发症发生率(包括假性动脉瘤、尿潴留、血肿、血管痉挛)。采用多因素logistic回归分析各途径血管造影失败的影响因素。

结果

桡动脉组的穿刺、止血、暴露、手术及术后恢复时间均较短(均P < 0.001)。桡动脉组的选择性血管造影成功率(93.75%)高于股动脉组(85.25%)(χ = 4.168,P = 0.041)。两组的穿刺成功率差异无统计学意义(χ = 0.235,P = 0.628)。桡动脉组的总体并发症发生率(2.50%)显著低于股动脉组(9.25%)(χ = 4.069,P = 0.044)。性别和低密度脂蛋白胆固醇水平是两种途径血管造影失败的显著预测因素(均P < 0.05)。

结论

DSA经桡动脉途径安全可行,在手术时间和并发症发生率方面具有优势,是临床首选方法。

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本文引用的文献

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Transradial versus Transfemoral artery catheterization: A comparative meta-analysis on cerebrovascular accidents.
Expert Rev Cardiovasc Ther. 2021 Feb;19(2):103-105. doi: 10.1080/14779072.2021.1860752. Epub 2020 Dec 29.
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