Distal Radial Artery Access for Coronary and Peripheral Procedures: A Multicenter Experience.
Distal Radial Artery Access for Coronary and Peripheral Procedures: A Multicenter Experience.
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DOI：
10.3390/jcm10245974
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发表时间：
2021-12-20
影响因子：
3.9
通讯作者：
Ruzsa Z
中科院分区：
文献类型：
--
作者：
Achim A;Kákonyi K;Jambrik Z;Nagy F;Tóth J;Sasi V;Hausinger P;Nemes A;Varga A;Bertrand OF;Ruzsa Z
引言：桡动脉远端入路（dRA）作为血管手术的替代入路最近在全球范围内流行。dRA的好处包括入口部位出血并发症的风险低、桡动脉闭塞率低以及改善患者和操作员的舒适度。这项大型多中心登记研究的目的是证明dRA在导管室各种常规手术中的可行性和安全性，范围从冠状动脉造影和经皮冠状动脉介入到外周手术。研究方法：该研究包括2019年1月至2021年4月在匈牙利两家中心通过dRA接受冠状动脉造影术、PCI或非冠状动脉手术的1240例患者。分析了基线患者特征、动脉穿刺次数和持续时间、手术成功率、交叉率、术后压迫时间、并发症、住院时间和不同的学习曲线。结果：患者平均年龄为66.4岁，66.8%的患者为男性。大多数患者（74.04%）接受了冠状动脉手术，而25.96%的患者接受了非冠状动脉介入治疗。在所有病例中，97%的患者在超声引导下成功穿刺dRA。2.58%的患者进行了穿刺部位交叉，主要通过对侧dRA。在经历了150例病例后，dRA成功率稳定在> 96%。我们的专用dRA逐步方案导致桡动脉（RA）开放率较高：出院时99.68%的患者可触及远端和近端RA脉搏。轻微血管并发症的发生率较低（1.5%）。50例病例的阈值足以让已经熟练的桡动脉操作员建立可靠的dRA入路手术方法。结论：在导管室的日常工作中实施远端桡动脉入路进行冠状动脉和非冠状动脉介入治疗是可行和安全的，具有可接受的学习曲线。
Introduction: Distal radial access (dRA) has recently gained global popularity as an alternative access route for vascular procedures. Among the benefits of dRA are the low risk of entry site bleeding complications, the low rate of radial artery occlusion, and improved patient and operator comfort. The aim of this large multicenter registry was to demonstrate the feasibility and safety of dRA in a wide variety of routine procedures in the catheterization laboratory, ranging from coronary angiography and percutaneous coronary intervention to peripheral procedures. Methods: The study comprised 1240 patients who underwent coronary angiography, PCI or noncoronary procedures through dRA in two Hungarian centers from January 2019 to April 2021. Baseline patient characteristics, number and duration of arterial punctures, procedural success rate, crossover rate, postoperative compression time, complications, hospitalization duration, and different learning curves were analyzed. Results: The average patient age was 66.4 years, with 66.8% of patients being male. The majority of patients (74.04%) underwent a coronary procedure, whereas 25.96% were involved in noncoronary interventions. dRA was successfully punctured in 97% of all patients, in all cases with ultrasound guidance. Access site crossover was performed in 2.58% of the patients, mainly via the contralateral dRA. After experiencing 150 cases, the dRA success rate plateaued at >96%. Our dedicated dRA step-by step protocol resulted in high open radial artery (RA) rates: distal and proximal RA pulses were palpable in 99.68% of all patients at hospital discharge. The rate of minor vascular complications was low (1.5%). A threshold of 50 cases was sufficient for already skilled radial operators to establish a reliable procedural method of dRA access. Conclusion: The implementation of distal radial artery access in the everyday routine of a catheterization laboratory for coronary and noncoronary interventions is feasible and safe with an acceptable learning curve.
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影响因子：
1.7
作者：
Davies, Rhian E.;Gilchrist, Ian C.
通讯作者：
Gilchrist, Ian C.
影响因子：
4.8
作者：
Aminian, Adel;Sgueglia, Gregory A.;Saito, Shigeru
通讯作者：
Saito, Shigeru
影响因子：
6.2
作者：
Kiemeneij, Ferdinand
通讯作者：
Kiemeneij, Ferdinand
影响因子：
3.7
作者：
Tang L;Wang F;Li Y;Zhao L;Xi H;Guo Z;Li X;Gao C;Wang J;Zhou L
通讯作者：
Zhou L
DOI：
10.1177/1526602820963022
发表时间：
2021-04
期刊：
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
影响因子：
--
作者：
Ruzsa Z;Csavajda Á;Nemes B;Deák M;Sótonyi P;Bertrand OF;Merkely B
通讯作者：
Merkely B