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冠状动脉导管插入术期间持续性桡动脉痉挛的处理：一个复杂的病例研究。

Managing Persistent Radial Artery Spasm During Coronary Catheterization: A Complex Case Study.

作者信息

Mager Riccardo, Gaspardone Carlo, Sofia Rosaria, Godino Cosmo

机构信息

Vita-Salute San Raffaele University, Milan, Italy.

Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

出版信息

Catheter Cardiovasc Interv. 2025 Aug;106(2):1260-1262. doi: 10.1002/ccd.31681. Epub 2025 Jun 9.

DOI:10.1002/ccd.31681
PMID:40490928
Abstract

This case report details the management of persistent radial artery spasm during coronary catheterization, unresponsive to standard pharmacotherapy. After conventional methods failed, deep sedation, neuromuscular blockade, and orotracheal intubation proved essential. We propose a structured step-wise approach to radial artery spasm, emphasizing adaptable strategies for treatment-resistant cases.

摘要

本病例报告详细介绍了冠状动脉导管插入术期间持续性桡动脉痉挛的处理情况，该痉挛对标准药物治疗无反应。在传统方法失败后，深度镇静、神经肌肉阻滞和气管插管被证明是必不可少的。我们提出了一种针对桡动脉痉挛的结构化逐步处理方法，强调针对治疗抵抗性病例的适应性策略。

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Managing Persistent Radial Artery Spasm During Coronary Catheterization: A Complex Case Study.冠状动脉导管插入术期间持续性桡动脉痉挛的处理：一个复杂的病例研究。
Catheter Cardiovasc Interv. 2025 Aug;106(2):1260-1262. doi: 10.1002/ccd.31681. Epub 2025 Jun 9.
2
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Catheter Cardiovasc Interv. 2025 Aug;106(2):1247-1254. doi: 10.1002/ccd.31675. Epub 2025 Jun 8.
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Radial artery flow-mediated dilation predicts arterial spasm during transradial coronary interventions.桡动脉血流介导的扩张可预测经桡动脉冠状动脉介入治疗中的动脉痉挛。
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Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-carterial nitroglycerin in transradial procedures: a randomized trial.经桡动脉介入操作中，穿刺前舌下含服硝酸甘油与传统动脉内注射硝酸甘油的有效性比较：一项随机试验。
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The efficacy of nitroglycerin to prevent radial artery spasm and occlusion during and after transradial catheterization: A systematic review and meta-analysis of randomized controlled trials.硝酸甘油预防经桡动脉穿刺过程中和穿刺后桡动脉痉挛和闭塞的疗效：一项随机对照试验的系统评价和荟萃分析。
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The effect of vasodilatory medications on radial artery spasm in patients undergoing transradial coronary artery procedures: a systematic review.血管舒张药物对经桡动脉冠状动脉介入手术患者桡动脉痉挛的影响：一项系统评价。
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本文引用的文献

1
Effect of Hand Dominance on Radial Artery Spasm and Occlusion: A Prospective Observational Study.手优势对桡动脉痉挛和闭塞的影响：一项前瞻性观察研究。
Angiology. 2024 Apr;75(4):340-348. doi: 10.1177/00033197231155599. Epub 2023 Feb 6.
2
Brachial Plexus Block for Removal of Retained Radial Artery Sheath.臂丛神经阻滞用于取出桡动脉鞘管残留
Cureus. 2022 Dec 28;14(12):e33068. doi: 10.7759/cureus.33068. eCollection 2022 Dec.
3
Clinical predictors and management for radial artery spasm: an Australian cross-sectional study.桡动脉痉挛的临床预测因素及处理：澳大利亚横断面研究。
BMC Cardiovasc Disord. 2023 Jan 18;23(1):33. doi: 10.1186/s12872-023-03042-z.
4
Radial Artery Access Complications: Prevention, Diagnosis and Management.桡动脉入路并发症：预防、诊断和管理。
Cardiovasc Revasc Med. 2022 Jul;40:163-171. doi: 10.1016/j.carrev.2021.12.007. Epub 2021 Dec 16.
5
A novel nonpharmacologic technique to remove entrapped radial sheath.一种用于移除嵌顿桡侧腱鞘的新型非药物技术。
Catheter Cardiovasc Interv. 2015 Jan 1;85(1):E35-8. doi: 10.1002/ccd.25593. Epub 2014 Aug 30.
6
Radial artery spasm during transradial coronary procedures.经桡动脉冠状动脉介入手术期间的桡动脉痉挛
J Invasive Cardiol. 2011 Dec;23(12):527-31.
7
Pre-emptive stellate ganglion block increases the patency of radial artery grafts in coronary artery bypass surgery.预防性星状神经节阻滞可提高冠状动脉搭桥手术中桡动脉移植物的通畅率。
Acta Anaesthesiol Scand. 2007 Apr;51(4):434-40. doi: 10.1111/j.1399-6576.2006.01260.x.