Wada Takeshi, Koizumi Jun, Takeuchi Takashi, Akutsu Akira, Tsuchiya Satoshi, Kubota Yoshihiro, Kondo Hiroshi, Fujimoto Hajime, Uno Takashi
Department of Radiology, Teikyo University School of Medicine, Japan.
Comprehensive Radiology Center, Chiba University Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2024 Jul 24;9(3):186-191. doi: 10.22575/interventionalradiology.2023-0024. eCollection 2024 Nov 1.
Distal transradial access through the anatomical snuffbox has been highlighted in recent research because it provides extremely low invasiveness. It has demonstrated its feasibility and safety for cardiac intervention. However, its characteristics for noncardiac intervention are not well known. This report aims to demonstrate the feasibility and safety of noncardiac intervention with distal transradial access, with identification of practical devices for procedures.
This retrospective study was conducted from May 2021 to December 2021 with consecutive patients who underwent distal transradial access for noncardiac intervention. This study analyzed patient physical information, procedural details, technical success rates, and distal transradial access-associated complications.
Nine patients (7 females, 2 males) aged 48-69 years (median: 57) were enrolled in this study. This study assessed 11 noncardiac procedures, such as transarterial infusion chemotherapy for head and neck malignancies ( = 4), embolization of visceral artery aneurysm ( = 2), embolization of renal angiomyolipoma ( = 2), percutaneous transluminal renal angioplasty ( = 1), bronchial artery embolization ( = 1), and diagnostic angiography ( = 1). The introducer sheath size was 4-6 French. Catheters respectively having nine tip shapes were used. Reverse curve catheters were used only in two cervical procedures. The technical success rate was 91% (10/11). Of the 11 procedures, only 1 (bronchial artery embolization) required conversion to transfemoral access. There was no complication associated with distal transradial access. Ultrasound evaluation after treatments revealed patent radial arteries in all patients.
Results revealed that distal transradial access is feasible with commercially available catheters and is safe for various noncardiac interventions.
经解剖鼻烟壶的远端桡动脉入路在最近的研究中受到关注，因为它具有极低的侵入性。它已证明在心脏介入治疗中的可行性和安全性。然而，其在非心脏介入治疗中的特点尚不清楚。本报告旨在证明远端桡动脉入路用于非心脏介入治疗的可行性和安全性，并确定适用于该操作的实用器械。
本回顾性研究于2021年5月至2021年12月对连续接受远端桡动脉入路非心脏介入治疗的患者进行。本研究分析了患者的身体信息、操作细节、技术成功率以及与远端桡动脉入路相关的并发症。
本研究纳入了9例年龄在48 - 69岁（中位数：57岁）的患者（7例女性，2例男性）。本研究评估了11例非心脏手术，如头颈部恶性肿瘤的经动脉灌注化疗（n = 4）、内脏动脉瘤栓塞（n = 2）、肾血管平滑肌脂肪瘤栓塞（n = 2）、经皮腔内肾血管成形术（n = 1）、支气管动脉栓塞（n = 1）和诊断性血管造影（n = 1）。导入鞘尺寸为4 - 6法国规格。使用了分别具有九种尖端形状的导管。仅在两个颈部手术中使用了反曲导管。技术成功率为91%（10/11）。在这十一个手术中，只有一例（支气管动脉栓塞）需要转为经股动脉入路。没有与远端桡动脉入路相关的并发症。治疗后的超声评估显示所有患者的桡动脉通畅。
结果表明，使用市售导管经远端桡动脉入路是可行的，并且对各种非心脏介入治疗是安全的。
