Kerrigan Jimmy, Paul Timir K, Patel Jay, Saad Walid, Morse Andrew, Haddad Elias, Chandler Angel, Emling Jonathan, Lichaa Hady
Ascension Saint Thomas Heart, Ascension Saint Thomas West Hospital, University of Tennessee Health Science Center Nashville, TN.
Ascension Saint Thomas Heart, Ascension Saint Thomas Midtown Hospital, University of Tennessee Health Science Center Nashville, TN.
US Cardiol. 2023 Oct 20;17:e16. doi: 10.15420/usc.2023.04. eCollection 2023.
Vascular access is a crucial step, which every interventional cardiologist needs to be skilled with to consistently achieve excellent periprocedural outcomes. Some operators argue that it is the most important aspect of the entire intervention. Hence, careful planning of vascular access in an individualized fashion - based on the patient's clinical status, anatomy, and technical requirements of the intervention - is the first step in securing optimal procedural safety and successful results. We briefly review multiple aspects of vascular access and management including site selection, ultrasound guidance, micro-puncture techniques, sheathless techniques, limb perfusion, clinical monitoring, large bore closure, and management of complications. Approaching every vascular access in a systematic way, even in emergent situations, allows operators to minimize the risk of complications, especially in an often severely ill patient population.
血管通路是关键步骤，每位介入心脏病专家都需熟练掌握，以持续实现出色的围手术期结果。一些操作者认为这是整个介入操作中最重要的方面。因此，基于患者的临床状况、解剖结构和介入操作的技术要求，以个体化方式精心规划血管通路，是确保最佳手术安全性和成功结果的第一步。我们简要回顾血管通路及管理的多个方面，包括部位选择、超声引导、微穿刺技术、无鞘技术、肢体灌注、临床监测、大口径闭合以及并发症的处理。即使在紧急情况下，以系统的方式处理每一个血管通路，能使操作者将并发症风险降至最低，尤其是在通常病情严重的患者群体中。
