Maeda Yasuto, Inoue Tadashi, Kagiyama Yoshiyuki, Takase Ryuta, Koteda Yusuke, Suda Kenji
Department of Pediatrics, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Pediatr Int. 2024 Jan-Dec;66(1):e15841. doi: 10.1111/ped.15841.
Transradial access (TRA) is not a common vascular access in children. We have been performing TRA actively to reduce puncture complications, and the purpose of this study was to investigate the safety and efficacy of TRA in young children.
The study included 29 patients aged 5-12 years who underwent diagnostic catheterization at Kurume University Hospital. Vascular access was placed through TRA in 11 of these patients and through transfemoral access (TFA) in 18 patients with comparable ages. We compared TRA with TFA using various demographic data.
The median age of TRA was 10 years (5-12 years) and that of TFA was 7 years (5-11 years). They were not significantly different. Transradial access showed an acceptably high success rate (91%), which was comparable with that of TFA (100%), although we had to switch to TFA in one patient in which the radial artery diameter was too small to puncture and due to failure of appropriate sedation and local anesthesia. A comparison between the two groups showed no significant differences in weight, puncture success rate, total time to completion of both arterial and venous puncture, or fluoroscopy time. However, none of the patients with TRA required post-catheter bed rest after removal of the arterial sheath, whereas patients with TFA required 6 h of bed rest. Although there were no puncture complications in group TRA, one patient with TFA had a subcutaneous hematoma.
Transradial access can be performed safely in young children and may be more beneficial than TFA.
经桡动脉穿刺入路（TRA）在儿童中并非常见的血管穿刺入路。我们一直在积极开展TRA以减少穿刺并发症，本研究的目的是探讨TRA在幼儿中的安全性和有效性。
本研究纳入了29例年龄在5至12岁之间、在久留米大学医院接受诊断性心导管检查的患者。其中11例患者通过TRA建立血管通路，18例年龄相仿的患者通过经股动脉穿刺入路（TFA）建立血管通路。我们使用各种人口统计学数据对TRA和TFA进行了比较。
TRA组的中位年龄为10岁（5至12岁），TFA组为7岁（5至11岁）。两者无显著差异。经桡动脉穿刺入路显示出较高的成功率（91%），与TFA组（100%）相当，不过有1例患者因桡动脉直径过小无法穿刺以及镇静和局部麻醉失败而不得不转为TFA。两组之间在体重、穿刺成功率、动脉和静脉穿刺完成总时间或透视时间方面无显著差异。然而，TRA组患者在拔除动脉鞘后均无需导管术后卧床休息，而TFA组患者需要卧床休息6小时。TRA组无穿刺并发症，而TFA组有1例患者出现皮下血肿。
经桡动脉穿刺入路在幼儿中可安全实施，可能比TFA更具优势。
