经桡动脉途径行外周介入的安全性与可行性  

Peripheral arterial intervention via transradial approach: evaluation of its safety and feasibility

作　　者：江海林[1] 孟小茜[1] 廖华强[1] 刘洪超[1] 顾亚峰 李西[1] 董伟华[1] JIANG Hailin;MENG Xiaoxi;LIAO Huaqiang;LIU Hongchao;GU Yafeng;LI Xi;DONG Weihua(Department of lnterventional Radiology,Affiliated Changzheng Hospital,Second Military Medical University,Shanghai 200003,China)

机构地区：[1]第二军医大学附属长征医院介入诊疗科,上海200003

出　　处：《介入放射学杂志》2018年第11期1027-1030,共4页Journal of Interventional Radiology

摘　　要：目的探讨经桡动脉途径行外周介入的可行性和安全性以及患者对经该途径手术的接受度。方法回顾性分析了408例患者共762例次经桡动脉途径的外周血管介入手术,其中肝癌化疗栓塞术610例次、消化道血管造影(+栓塞)术31例次、骨肿瘤术前栓塞术70例次、膀胱癌化疗栓塞术15例次、妇科肿瘤化疗栓塞术31例次、肾动脉成形术5例次。对桡动脉穿刺成功率、导管进入靶血管并完成后续操作的手术成功率、相关并发症及患者接受度进行分析。结果桡动脉穿刺成功率为97.38%(742/762)。经桡动脉途径的手术成功率为98.11%(728/742)。3例次插管过程中出现桡动脉痉挛,9例次术后出现皮下小范围血肿或淤血,9例次术后出现桡动脉搏动减弱,1例次出现前臂疼痛。97例曾行经股动脉操作的患者中,95例更倾向再次手术时行经桡动脉途径。结论经桡动脉途径行外周血管介入是安全可行的,患者接受度高。Objective To discuss the feasibility and safety of transradial approach in performing peripheral arterial intervention, and to evaluate the patient acceptance for this interventional approach.Methods The clinical data of a total of 762 peripheral arterial intervention procedures performed in 408 patients that were carried out via radial artery approach were reviewed. The interventional procedures included transcatheter arterial chemoembolization（TACE, n =610）, angiography of digestive tract（together with embolization, n =31）, preoperative embolization of bone tumors（n =70）, embolization of bladder cancer（together with chemotherapy, n=15）, embolization of gynecological tumors（together with chemotherapy, n=13） and renal artery angioplasty（n =5）. The success rate of radial artery puncture, the success rate of operation（i.e. catheter entering target vessel and completing subsequent interventional manipulation）, the procedure-related complications and the patient acceptance were recorded and the results were analyzed.Results The success rate of radial artery puncture was 97.38%（742/762）. The operative success rate of interventional procedures using transradial approach was 98.11%（728/742）. During the catheterization radial artery spasm occurred in 3 patients, postoperative minor subcutaneous hematoma or congestion was seen in9 patients, postoperative weakened radial artery pulsation was observed in 9 patients, and one patient developed forearm pain. Among 97 patients who had previously received interventional procedure via femoral artery access, 95 patients preferred to perform the second interventional procedure with transradial approach.Conclusion For the performance of peripheral arterial interventional procedure, the use of transradial approach is clinically safe and feasible, besides, this technique has higher patient acceptance.

关 键 词：经桡动脉途径 介入放射学 外周血管介入 

分 类 号：R815[医药卫生—放射医学]