远端桡动脉入路在下肢动脉疾病腔内治疗中的应用

陈尚雄; 张彬; 郝迎学; 肖航

doi:10.11659/jjssx.E02301070

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远端桡动脉入路在下肢动脉疾病腔内治疗中的应用

血管专栏 | 更新时间：2023-11-24

- 远端桡动脉入路在下肢动脉疾病腔内治疗中的应用
- Application of distal radial artery approach in endovascular treatment of lower limb arterial diseases
- 局解手术学杂志 2023年32卷第11期页码：942-944
- 作者机构：
  
  陆军军医大学第一附属医院血管外科，重庆 400038
- 作者简介：
  
  肖航，E-mail：614232643@qq.com
- 基金信息：
  
  重庆市沙坪坝区决策咨询与管理项目(沙科局发［2022］27号)
- DOI：10.11659/jjssx.E02301070
  中图分类号： R654.4
- 纸质出版日期：2023-11-25，
  
  收稿日期：2023-01-16，
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陈尚雄,张彬,郝迎学等.远端桡动脉入路在下肢动脉疾病腔内治疗中的应用[J].局解手术学杂志,2023,32(11):942-944.

CHEN Shang-xiong,ZHANG Bin,HAO Ying-xue,et al.Application of distal radial artery approach in endovascular treatment of lower limb arterial diseases[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(11):942-944.
陈尚雄,张彬,郝迎学等.远端桡动脉入路在下肢动脉疾病腔内治疗中的应用[J].局解手术学杂志,2023,32(11):942-944. DOI： 10.11659/jjssx.E02301070.

CHEN Shang-xiong,ZHANG Bin,HAO Ying-xue,et al.Application of distal radial artery approach in endovascular treatment of lower limb arterial diseases[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(11):942-944. DOI： 10.11659/jjssx.E02301070.

摘要

目的

探讨经解剖鼻烟壶区远端桡动脉入路在下肢动脉疾病腔内治疗中的疗效。

方法

回顾性分析我院因下肢动脉疾病行腔内治疗的11例患者的临床资料，统计患者穿刺及手术相关指标。

结果

所有患者均成功穿刺远端桡动脉，穿刺成功时间（2.8±1.5）min，穿刺次数（1.6±0.6）次，仅1例穿刺点周围淤青，无穿刺部位相关的严重并发症发生；患者手术均成功进行，手术成功率100%，其中机械吸栓3例，球囊扩张3例，球囊扩张+支架置入4例，股动脉假性动脉瘤硬化治疗1例；干预血管总数16根，平均（1.45±0.52）根，手术时间（114.3±58.4）min，X射线照射时间（45.3±23.6）min，造影剂用量（147.3±54.6）mL，围术期未发生重大并发症。

结论

远端桡动脉入路是一种安全可行的下肢动脉疾病腔内治疗的手术入路，有较高的穿刺成功率和较低的并发症并发生率。但由于导管长度限制，远端桡动脉入路在处理膝下动脉病变时有一定局限性。

Abstract

Objective

To investigate the efficacy of distal radial artery approach through anatomical snuff box in endovascular treatment of lower limb arterial diseases.

Methods

The clinical data of 11 patients who underwent endovascular treatment for lower limb arterial diseases in our hospital were retrospectively analyzed， and the relevant indexes of puncture and surgery were counted.

Results

The distal radial arteries of 11 patients were punctured successfully， with an average puncture time of （2.8±1.5） minutes and the puncture times of （1.6±0.6）. There was only 1 case of bruising around the puncture site， and no serious complications related to the puncture site occurred. All the patients underwent successful surgery with a success rate of 100%， including 3 cases of mechanical thrombectomy， 3 cases of balloon dilation， 4 cases of balloon dilation and stenting， and 1 case of femoral pseudoaneurysm sclerosis treatment. The total intervention number of blood vessels was 16 with an average of （1.45±0.52） vessels， the operation time was （114.3±58.4） minutes， and the time of X-ray irradiation was （45.3±23.6） minutes， with the amount of contrast agent of （147.3±54.6） mL. There was no major complications in the perioperative period.

Conclusion

The distal radial artery approach is a safe and feasible surgical approach for endovascular treatment of lower limb artery diseases， with relatively high puncture success rate and low incidence of complications； while it has some limitations in the management of infra-popliteal artery lesions due to the limitation of catheter length.

关键词

解剖鼻烟壶区远端桡动脉桡动脉入路下肢动脉疾病腔内治疗

Keywords

anatomical snuff boxdistal radial arteryradial artery approachlower limb artery diseasesendovascular treatment

references

Klein-Wiele O，Baliota M，Kara K，et al.Safety and efficacy of clip-based vs. suture mediated vascular closure for femoral access hemostasis：a prospective randomized single center study comparing the StarClose and the ProGlide device［J］.Catheter Cardiovasc Interv，2018，91（3）：402-407.doi：10.1002/ccd.27116http://dx.doi.org/10.1002/ccd.27116.

DeRubertis BG，Faries PL，McKinsey JF，et al.Shifting paradigms in the treatment of lower extremity vascular disease：a report of 1 000 percutaneous interventions［J］.Ann Surg，2007，246（3）：415-422.doi：10.1097/SLA.0b013e31814699a2http://dx.doi.org/10.1097/SLA.0b013e31814699a2.

Spies JB，Berlin L.Complications of femoral artery puncture［J］.AJR Am J Roentgenol，1998，170（1）：9-11.doi：10.2214/ajr.170. 1.9423587http://dx.doi.org/10.2214/ajr.170.1.9423587.

Kiemeneij F.Left distal transradial access in the anatomical snuffbox for coronary angiography （ldTRA） and interventions （ldTRI）［J］.EuroIntervention，2017，13（7）：851-857.doi：10.4244/EIJ-D-17-00079http://dx.doi.org/10.4244/EIJ-D-17-00079.

Al-Azizi KM，Grewal V，Gobeil K，et al.The left distal transradial artery access for coronary angiography and intervention：a US experience［J］.Cardiovasc Revasc Med，2019，20（9）：786-789.doi：10.1016/j.carrev.2018.10.023http://dx.doi.org/10.1016/j.carrev.2018.10.023.

Hamandi M，Saad M，Hasan R，et al.Distal versus conventional transradial artery access for coronary angiography and intervention：a meta-analysis［J］.Cardiovasc Revasc Med，2020，21（10）：1209-1213.doi：10.1016/j.carrev.2020.03.020http://dx.doi.org/10.1016/j.carrev.2020.03.020.

Chen SX，Zhang B，Hao YX，et al.Percutaneous mechanical thrombectomy for acute superior mesenteric artery embolism via left distal transradial access in the anatomical snuffbox［J］.Quant Imaging Med Surg，2022，12（2）：1641-1646.doi：10.21037/qims-21-357http://dx.doi.org/10.21037/qims-21-357.

Samal AK，White CJ.Percutaneous management of access site complications［J］.Catheter Cardiovasc Interv，2002，57（1）：12-23.doi：10.1002/ccd.10179http://dx.doi.org/10.1002/ccd.10179.

Campeau L.Percutaneous radial artery approach for coronary angiography［J］.Cathet Cardiovasc Diagn，1989，16（1）：3-7.doi：10.1002/ccd.28016http://dx.doi.org/10.1002/ccd.28016.

Valgimigli M，Gagnor A，Calabró P，et al.Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management：a randomised multicentre trial［J］.Lancet，2015，385（9986）：2465-2476.doi：10.1016/S0140-6736（15）60292-6http://dx.doi.org/10.1016/S0140-6736（15）60292-6.

Posham R，Biederman DM，Patel RS，et al.Transradial approach for noncoronary interventions：a single-center review of safety and feasibility in the first 1，500 cases［J］.J Vasc Interv Radiol，2016，27（2）：159-166.doi：10.1016/j.jvir.2015.10.026http://dx.doi.org/10.1016/j.jvir.2015.10.026.

Windecker S，Kolh P，Alfonso F，et al.2014 ESC/EACTS guidelines on myocardial revascularization：the task force on myocardial revascularization of the European Society of Cardiology （ESC） and the European Association for Cardio-Thoracic Surgery （EACTS） developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions （EAPCI）［J］.Eur Heart J，2014，35（37）：2541-2619.doi：10.1093/eurheartj/ehu278http://dx.doi.org/10.1093/eurheartj/ehu278.

Corcos T.Distal radial access for coronary angiography and percutaneous coronary intervention：a state-of-the-art review［J］.Catheter Cardiovasc Interv，2019，93（4）：639-644.doi：10.1002/ccd.28016http://dx.doi.org/10.1002/ccd.28016.

Majmundar N，Patel P，Gadhiya A，et al.Left distal radial access in patients with arteria lusoria：insights for cerebral angiography and interventions［J］.J Neurointerv Surg，2020，12（12）：1231-1234.doi：10.1136/neurintsurg-2020-016199http://dx.doi.org/10.1136/neurintsurg-2020-016199.

Davies RE，Gilchrist IC.Dorsal （distal） transradial access for coronary angiography and intervention［J］.Interv Cardiol Clin，2019，8（2）：111-119.doi：10.1016/j.iccl.2018.11.002http://dx.doi.org/10.1016/j.iccl.2018.11.002.

Pua U，Sim J，Quek L，et al.Feasibility study of "snuffbox" radial access for visceral interventions［J］.J Vasc Interv Radiol，2018，29（9）：1276-1280.doi：10.1016/j.jvir.2018.05.002http://dx.doi.org/10.1016/j.jvir.2018.05.002.

van Dam L，Geeraedts T，Bijdevaate D，et al.Distal radial artery access for noncoronary endovascular treatment is a safe and feasible technique［J］.J Vasc Interv Radiol，2019，30（8）：1281-1285.doi：10.1016/j.jvir.2019.01.011http://dx.doi.org/10.1016/j.jvir.2019.01.011.

Park SE，Cho SB，Baek HJ，et al.Clinical experience with distal transradial access for endovascular treatment of various noncoronary interventions in a multicenter study［J］.PLoS One，2020，15（8）：e0237798.doi：10.1371/journal.pone.0237798http://dx.doi.org/10.1371/journal.pone.0237798.

Susanu S，Angelillis M，Giannini C，et al.Radial access for percutaneous coronary procedure：relationship between operator expertise and complications［J］.Clin Exp Emerg Med，2018，5（2）：95-99.doi：10.15441/ceem.17.210http://dx.doi.org/10.15441/ceem.17.210.

Oliveira M，Navarro EC，Kiemeneij F.Distal transradial access as default approach for coronary angiography and interventions［J］.Cardiovasc Diagn Ther，2019，9（5）：513-519.doi：10.21037/cdt.2019.09.06http://dx.doi.org/10.21037/cdt.2019.09.06.

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