长导丝交换技术在经桡动脉途径脑血管造影术中的应用  

Application of long guidewire exchange technique in cerebral angiography via radial artery access

作　　者：杨海华[1] 周晓梅[1] 刘立斌[1] 

机构地区：[1]首都医科大学大兴医院神经内科,北京102600

出　　处：《介入放射学杂志》2017年第8期676-680,共5页Journal of Interventional Radiology

摘　　要：目的探讨长导丝交换技术在经桡动脉途径脑血管造影术中应用的有效性和安全性。方法回顾性分析2014年6月至2016年5月在首都医科大学大兴医院接受桡动脉途径脑血管造影术患者257例临床资料,将其中186例Ⅱ型、Ⅲ型主动脉弓患者依据Simmons-2导管成襻技术不同分为试验组(n=90)和常规组(n=96)。观察两组桡动脉穿刺成功率、Simmons-2导管成襻成功率、弓上动脉插管成功率、造影时间、曝光时间、并发症等情况。结果两组患者桡动脉穿刺均获成功。试验组和常规组Simmons-2导管成襻成功率分别为97.8%和72.9%,试验组均明显高于常规组(P<0.05);左锁骨下动脉、左颈总动脉、右颈总动脉插管成功率分别为97.8%、97.8%、97.8%和72.9%、72.9%、72.9%,试验组均明显高于常规组(P<0.05),两组右锁骨下动脉、右椎动脉插管成功率差异无统计学意义(P>0.05);造影时间分别为(22.5±9.4)min、(28.3±8.3)min,X线辐射时间分别为(8.9±4.5)min、(12.6±6.5)min,试验组均明显少于常规组(P=0.017,P=0.035);并发症发生率分为别为4.4%、5.2%(P>0.05),两组均未出现颅内动脉栓塞事件、穿刺出血、动脉闭塞等严重并发症。结论长导丝交换技术可提高Simmons-2导管成襻、主动脉弓上动脉插管成功率,缩短造影时间及X线辐射时间,有效性及安全性高,可作为Ⅱ型、Ⅲ型主动脉弓患者经桡动脉途径脑血管造影术常用技术。Objective To investigate the efficacy and safety of long guidewire exchange technique in performing cerebral angiography via radial artery approach. Methods The clinical data of 257 patients, who received cerebral angiography during the period from June 2014 to May 2016 at Daxing Hospital of Capital Medical University, Beijing, China, were retrospectively analyzed. Among the 257 patients, 186 had type Ⅱ or type Ⅲ aortic arch. According to the different looping technologies for Simmons- 2 catheter used in the performance of cerebral angiography, these 186 patients were divided into the study group （n=90） and the routine group （n=96）. The success rate of radial artery puncturing, the success rate of Simmons-2 catheter looping formation, the success rate of supra-arch arterial catheterization, the time spent for angiography, the radiation exposure time, complications, etc. were recorded. Results The success rate of radial artery puncturing was 100% in both groups. The success rate of Simmons-2 catheter looping formation in the study group was 97.8%, which was significantly higher than 72.9% in the routine group （P〈0.05）. The success rates of catheterization for the left subclavian artery, left common carotid artery and right carotid artery in the study group were 97.8%, 97.8% and 97.8% respectively, which were remarkably higher than 72.9%, 72.9% and 72.9% respectively in the routine group （P〈0.05）. No statistically significant difference in the success rates of catheterization for right subclavian artery and for right vertebral artery existed between the two groups （P〉0.05）. The time spent for angiography in the study group and the routine group was （22.5±9.4） min and （28.3±8.3） min respectively. The radiation exposure time in the study group was （8.9±4.5） min, which was obviously lower than （12.6±6.5） min in the routine group （P=0.017 and P=0.035, respectively）. The incidences of complications in the study group and the routine group were 4.4% and 5.2% respectiv

关 键 词：脑血管造影 桡动脉 导管 

分 类 号：R743[医药卫生—神经病学与精神病学]