Sano Arata, Sugimoto Takeshi, Iwasaki Tomoya, Miki Tomonori, Takai Shigeki, Wakana Noriyuki, Zen Kan, Yamada Hiroyuki, Matoba Satoaki
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Cardiovascular Medicine, Kyoto Tanabe Central Hospital, 6-1-6 Tanabe chuo, Kyotanabe-city, Kyoto, 610-0334, Japan.
Int J Cardiovasc Imaging. 2025 Mar;41(3):467-475. doi: 10.1007/s10554-025-03328-7. Epub 2025 Jan 8.
Endovascular treatment (EVT) for patients with lower extremity artery disease is widely used as a less invasive alternative to surgical bypass. Recently, transradial artery intervention has gained popularity owing to its minimally invasive nature. The distance from the radial artery to the target vessel is critical for success; however, effective pre-assessment methods have not yet been established. This study aimed to evaluate the usefulness of predistance measurements from the left radial artery using simple computed tomography (CT) images. In this study, distance measurements were performed from the left radial artery to the left and right iliac artery bifurcations and from the left radial artery to the common femoral artery at the upper femoral border. These distances, measured using CT images before and after the lower-extremity contrast study, were compared with the distances identified during the lower-extremity contrast study. Distances measured using simple CT images showed a high correlation with the distances identified during the lower-extremity contrast examination (r = 0.9317, p < 0.0001; from the left radial artery to the left and right iliac artery bifurcation; r = 0.9402, p < 0.0001; and from the left radial artery to the right common femoral artery at the upper femoral border). Our results suggest that pre-distance measurement using simple CT images can be a useful tool for EVT using the left radial artery approach. Although future large-scale studies are required, this technique merits consideration owing to its widespread adoption in clinical practice.
下肢动脉疾病患者的血管内治疗（EVT）作为一种侵入性较小的手术旁路替代方法被广泛应用。最近，经桡动脉介入因其微创特性而受到欢迎。桡动脉到目标血管的距离对手术成功至关重要；然而，尚未建立有效的术前评估方法。本研究旨在评估使用简单计算机断层扫描（CT）图像测量左桡动脉预距离的实用性。在本研究中，测量了从左桡动脉到左右髂动脉分叉处的距离，以及从左桡动脉到股骨上缘处股总动脉的距离。在下肢造影检查前后使用CT图像测量的这些距离，与下肢造影检查期间确定的距离进行了比较。使用简单CT图像测量的距离与下肢造影检查期间确定的距离高度相关（从左桡动脉到左右髂动脉分叉处，r = 0.9317，p < 0.0001；从左桡动脉到股骨上缘处右股总动脉，r = 0.9402，p < 0.0001）。我们的结果表明，使用简单CT图像进行预距离测量可以成为采用左桡动脉入路进行EVT的有用工具。尽管未来需要大规模研究，但由于该技术在临床实践中的广泛应用，值得考虑。
