Feng Feng, Li Nan, Zhao Zijian, Liu He, Qi Le, Zhang Zhenfeng, Wang Haoran, Lin Chao, Zhang Deng, Han Feng, Xu Yifan, Wang Liwei, Cao Lei, Li Jingjin, Lu Hua
Department of Anesthesiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Department of Anesthesiology, Huzhou Central Hospital, Huzhou, China.
iScience. 2024 Sep 10;27(10):110914. doi: 10.1016/j.isci.2024.110914. eCollection 2024 Oct 18.
Radial artery spasm (RAS) occurs in around 50% of patients who undergo interventional aneurysm surgery through the radial artery approach, leading to suboptimal long-term recovery for some. We suggested using brachial plexus block (BPB) to enhance surgical impact on the radial artery, and we confirmed that preconditioning with BPB effectively reduces RAS occurrence and improves prognosis. A total of 177 patients were randomly assigned to either the BPB group or the control group. The main outcome measure was diagnosing RAS incidence through intraoperative angiography, characterized by defects at vessel edges during radial artery angiography. In the control group, RAS occurred in 62.5% (55 out of 88), while it only appeared in 9.0% (8 out of 89) in the BPB group-a significant absolute difference (-53.5 percentage points). The findings suggest that BPB may be an effective strategy to reduce intraoperative RAS incidence in patients undergoing transradial access (TRA) for intracranial aneurysm interventional surgery.
桡动脉痉挛(RAS)发生在约50%经桡动脉途径进行介入性动脉瘤手术的患者中,导致部分患者长期恢复不佳。我们建议使用臂丛神经阻滞(BPB)来增强手术对桡动脉的影响,并证实BPB预处理可有效降低RAS的发生率并改善预后。总共177例患者被随机分配到BPB组或对照组。主要结局指标是通过术中血管造影诊断RAS发生率,其特征是桡动脉血管造影时血管边缘出现缺损。在对照组中,RAS发生率为62.5%(88例中有55例),而在BPB组中仅为9.0%(89例中有8例)——绝对差异显著(-53.5个百分点)。研究结果表明,BPB可能是一种有效的策略,可降低接受经桡动脉入路(TRA)进行颅内动脉瘤介入手术患者的术中RAS发生率。