神经介入治疗中桡动脉闭塞重复再通安全性和可行性分析  

Repeated recanalization of radial artery occlusion in neurointerventional therapy:analysis of its safety and feasibility

作　　者：蔡然泽 吴剑 齐飚 CAI Ranze;WU Jian;QI Biao(Department of Neurosurgery,Xiamen Branch,Affiliated Zhongshan Hospital of Fudan University,Xiamen,Fujian Province 361015,China)

机构地区：[1]复旦大学附属中山医院厦门医院神经外科,福建厦门361015

出　　处：《介入放射学杂志》2024年第10期1053-1056,共4页Journal of Interventional Radiology

摘　　要：目的探讨桡动脉闭塞(radial artery occlusion,RAO)重复再通用于神经介入治疗的安全性和可行性。方法回顾性分析2022年6月至2023年7月在复旦大学附属中山医院厦门医院接受桡动脉入路(transradial access,TRA)介入手术后出现RAO的18例脑血管病患者基线、手术、超声检查、手术相关并发症等临床资料。结果18例患者中7例、11例分别接受2次、3次同侧TRA手术。所有患者首次脑血管造影检查后出现RAO,后续RAO穿刺再通后均成功进行神经介入治疗,动静脉畸形3例,动脉瘤13例,动脉闭塞2例。共行RAO血栓处穿刺术29次,成功再通23次,成功率79.3%。早期RAO再通后(8.8±8.7)d,超声检查提示14例患者成功再通,4例持续闭塞;13例患者首次RAO再通随访(7.8±2.7)个月后,超声检查提示4例成功再通,9例持续闭塞。随访期间未发现严重并发症。结论重复经RAO原位穿刺再通后行神经介入治疗安全可行。Objective To investigate the safety and feasibility of repeated recanalization of radial artery occlusion(RAO)in neurointerventional therapy.Methods The clinical data,including general information,surgery,ultrasonography,and surgery-related complications,of 18 patients with cerebrovascular diseases,who developed RAO after receiving transradial access(TRA)intervention at the Xiamen Branch of Affiliated Zhongshan Hospital of Fudan University of China between June 2022 and July 2023,were retrospectively analyzed.Results Of 18 patients,7 received two consecutive same-side TRA procedures and 11 received three consecutive same-side TRA procedures.RAO occurred in all patients after the initial cerebrovascular angiography,and subsequent neurointerventional treatment was successfully accomplished after RAO recanalization.The cerebrovascular diseases included arteriovenous malformations(n=3),arterial aneurysm(n=13),and arterial occlusion(n=2).A total of 29 times of puncturing at the site of RAO thrombus were carried out,including 23 times of successful recanalization(success rate being 79.3%).At(8.8±8.7)days after the first-time RAO recanalization,ultrasonography indicated that successful recanalization was obtained in 14 patients and persistent occlusion was seen in 4 patients.Thirteen patients were followed up for(7.8±2.7)months after the initial RAO recanalization,and the ultrasonography revealed that successful recanalization was obtained in 4 patients and persistent occlusion was seen in 9 patients.No severe complications occurred during the follow-up period.Conclusion In situ puncture of the RAO site after its recanalization to perform neurointerventional treatments is clinically safe and feasible.

关 键 词：桡动脉入路 桡动脉闭塞 神经介入治疗 

分 类 号：R651[医药卫生—外科学]