摘要
目的探讨经桡动脉入路(TRA)在脑血管介入诊疗中的安全性和可行性。方法回顾性分析2019年7月至2021年2月南京医科大学第一附属医院神经外科连续收治的48例采用TRA行脑血管介入诊疗患者的临床资料,其中脑血管造影25例(52.1%),颅内动脉瘤治疗19例(39.6%),脑血管畸形4例(8.3%)。TRA行脑血管介入诊疗过程中,使用6 F桡动脉鞘及6 F Envoy导引导管或5 F Simmons导管。观察记录TRA行脑血管介入诊疗手术成功率、穿刺时间、手术X线摄影时间、手术相关卒中并发症、穿刺点局部并发症及术后患者桡动脉通畅性。结果48例患者TRA手术技术成功率为100.0%;经桡动脉穿刺置鞘时间为(5.8±2.8)min,25例局部麻醉造影诊断患者术中X线摄影时间为(7.5±2.6)min,23例全身麻醉手术治疗患者术中X线摄影时间为(32.8±5.6)min。无患者出现手术相关的卒中并发症。3例患者出现穿刺相关并发症,其中2例出现穿刺点血肿,1例出现皮下淤血。出院前48例患者桡动脉通畅性评估显示桡动脉血流皆通畅。结论TRA行脑血管介入诊疗安全可行。
Objective To investigate the safety and feasibility of transradial approach(TRA)in cerebrovascular intervention.Methods The clinical data of 48 patients received cerebrovascular intervention with TRA from the Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.Among them,25 patients(52.1%)received cerebral angiograms alone,19 patients(39.6%)treated for intracranial aneurysms and 4 patients(8.3%)for cerebrovascular malformations.In the process of diagnosis and treatment of cerebrovascular intervention with TRA,6 F sheath of radial artery and 6 F Envoy guiding catheter or 5 F Simmons catheter were used.The success rate of cerebrovascular interventions performed with TRA,puncture time,duration of operative X-ray radiography,procedure-related stroke complications,local complications at the puncture site and postoperative radial artery patency of the patients were observed and recorded.Results TRA was performed in all 48 patients with a technical success rate of 100.0%.The time to sheath via radial artery puncture was(5.8±2.8)min in 48 patients.The intraoperative X-ray radiography time was(7.5±2.6)min in 25 patients receiving cerebral angiograms under local anesthesia and(32.8±5.6)min in 23 patients receiving intervention under general anesthesia.Puncture-related complications occurred in 3 patients,including 2 patients with hematoma at the puncture site and 1 patient with subcutaneous ecchymosis.All 48 patients had radial artery patency prior to discharge.Conclusion In cerebrovascular intervention,interventional therapy with TRA is clinically safe and feasible.
作者
沈榆棋
常晗晓
张广见
李征
徐修鹏
林超
路华
Shen Yuqi;Chang Hanxiao;Zhang Guangjian;Li Zheng;Xu Xiupeng;Lin Chao;Lu Hua(Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital),Nanjing,Jiangsu 210029,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2021年第5期320-323,共4页
Chinese Journal of Cerebrovascular Diseases
基金
国家自然科学基金青年科学基金项目(81901258)
江苏省卫生计生委科研课题(H2017022)。
关键词
桡动脉入路
脑血管
介入
Transradial approach
Cerebrovascular
Intervention
