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经桡动脉途径行心脏导管插入术的血管并发症

Vascular Complications of Transradial Access for Cardiac Catheterization.

作者信息

Riangwiwat Tanawan, Blankenship James C

机构信息

Cardiology Department, Geisinger Medical Center Danville, PA.

Cardiology Division, University of New Mexico Albuquerque, NM.

出版信息

US Cardiol. 2021 Mar 8;15:e04. doi: 10.15420/usc.2020.23. eCollection 2021.

Abstract

Transradial access has been increasingly adopted for cardiac catheterization. It is crucial for operators to recognize potential vascular complications associated with radial artery access. Prevention, early detection, and prompt treatment of vascular complications are essential to prevent serious morbidities. This review aims to raise awareness of transradial access vascular complications. Radial artery spasm is treated with intra-arterial verapamil and/or nitroglycerine. Hemorrhagic complications, such as perforation, hematoma, arteriovenous fistula, and pseudoaneurysm, are treated with prolonged compression. Patent hemostasis and adequate anticoagulation are used to prevent radial artery occlusion. Hand ischemia is a rare complication not associated with abnormal results of the Allen or Barbeau test, and can be treated with intraarterial verapamil, IV heparin, and IV diltiazem. Finally, an attentive monitoring protocol for the timely detection of vascular complications should be implemented in daily practice.

摘要

经桡动脉途径已越来越多地应用于心脏导管插入术。对于操作者来说,认识到与桡动脉穿刺相关的潜在血管并发症至关重要。血管并发症的预防、早期发现和及时治疗对于预防严重疾病至关重要。本综述旨在提高对经桡动脉途径血管并发症的认识。桡动脉痉挛用动脉内维拉帕米和/或硝酸甘油治疗。出血性并发症,如穿孔、血肿、动静脉瘘和假性动脉瘤,采用延长压迫治疗。采用有效的止血和适当的抗凝措施预防桡动脉闭塞。手部缺血是一种罕见的并发症,与艾伦试验或巴博试验结果异常无关,可用动脉内维拉帕米、静脉注射肝素和静脉注射地尔硫䓬治疗。最后,应在日常实践中实施细致的监测方案,以便及时发现血管并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc15/11664788/d9d9f3ad1371/usc-15-e04-g001.jpg

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