Heenan S D, Grubnic S, Buckenham T M, Belli A M
Department of Radiology, St. George's Healthcare Trust, London, UK.
Clin Radiol. 1996 Mar;51(3):205-9. doi: 10.1016/s0009-9260(96)80324-2.
to retrospectively evaluate brachial artery puncture at the antecubital fossa with regard to the indications for and complications arising from the procedure.
Sixty-two cumulative brachial artery punctures in fifty-three patients over a 5-year-period were retrospectively studies.
In the majority of cases the brachial approach was utilised in order to avoid groin puncture in patients with absent femoral pulses or recent graft surgery. Occasionally it was performed as a more direct method of assessing upper limb arterial anatomy. Catheter sizes ranged from 3F to 8F. Fifty-one (82%) of the procedures were diagnostic and 11 (18%) were interventional. Glyceryl trinitrate was routinely administered. The overall incidence of complications was low (8%) and included haematoma and arterial spasm. None required surgical intervention and all resolved without permanent sequelae.
Brachial artery puncture at the antecubital fossa is a suitable site of access for both diagnostic and interventional procedures. Potential limitations are the long distance from puncture site to that of intervention and damage to the brachial artery can result in upper limb ischaemia. Percutaneous brachial artery puncture at the antecubital fossa is, however, a low-risk alternative to either intravenous digital subtraction angiography or axillary artery puncture in patients in whom the femoral approach is contraindicated.
回顾性评估肘前窝肱动脉穿刺的手术指征及并发症。
回顾性研究了53例患者在5年期间累计62次肱动脉穿刺情况。
在大多数情况下，采用肱动脉入路是为了避免对股动脉搏动消失或近期有移植手术的患者进行腹股沟穿刺。偶尔，它作为评估上肢动脉解剖结构的更直接方法进行。导管尺寸范围为3F至8F。51例（82%）手术为诊断性，11例（18%）为介入性。常规给予硝酸甘油。并发症总发生率较低（8%），包括血肿和动脉痉挛。无一例需要手术干预，所有并发症均自行缓解，无永久性后遗症。
肘前窝肱动脉穿刺是诊断和介入手术的合适入路部位。潜在的局限性是从穿刺部位到干预部位的距离较远，肱动脉损伤可导致上肢缺血。然而，对于禁忌股动脉入路的患者，肘前窝经皮肱动脉穿刺是静脉数字减影血管造影或腋动脉穿刺的低风险替代方法。
