The Effect of Vascular Morphology on Selective Left Vertebral Artery Catheterization in Right-sided Radial Artery Cerebral Angiography
The Effect of Vascular Morphology on Selective Left Vertebral Artery Catheterization in Right-sided Radial Artery Cerebral Angiography
复制标题
血管形态学对右侧桡动脉脑血管造影选择性左椎动脉插管的影响
DOI：
10.1016/j.avsg.2018.08.112
复制
发表时间：
2019-04-01
影响因子：
1.5
通讯作者：
Huang, Jianmin
中科院分区：
文献类型：
--
作者：
Luo, Ning;Qi, Weiwei;Huang, Jianmin
背景：本研究的目的是通过回顾性研究，确定通过右侧桡动脉脑血管造影入路时，血管形态及相关因素对左椎动脉选择性动脉插管成功的影响。方法：纳入接受过诊断性脑血管造影的患者，并记录其病史、导管类型和血管形态。 结果：2014年2月至2015年12月共入组205例患者，按照既定标准排除后，161例患者纳入最终分析。所有患者双侧锁骨下动脉和双侧颈总动脉选择性置管均成功，其中左侧椎动脉选择性置管成功率为82.0%。左椎动脉置管成功率与左椎动脉与左锁骨下动脉夹角呈正相关（P < 0.001），以90度为分界点，无无名动脉扭曲患者的成功率较高（90.2-75.0%），但无统计学意义。但主动脉形态并不影响左侧椎动脉选择性置管的成功率（P=0.189），左侧椎动脉占优势（91.0%，81/89）或平衡型（84.7%，61/72）选择性置管成功率无显着性差异（P=0.231）。共有 0.9% (2/161) 的患者出现手术相关并发症。这两名患者在术后2小时放气时均出现穿刺点出血。结论：左侧椎动脉与左侧锁骨下动脉夹角是影响右侧桡动脉脑血管造影中左侧椎动脉选择性置管成功率的主要血管相关形态因素，而无名动脉扭曲对其成功率的影响也较为有限。
Background: The aim of this study is to determine, via retrospective study, the effects of vascular morphology and related factors on the success of selective arterial catheterization of the left vertebral artery when approached via right-sided radial artery cerebral angiography.Methods: Patients who had undergone diagnostic cerebral angiography were enrolled, and their medical history, catheter type, and vessel morphology were analyzed.Results: A total of 205 patients were enrolled in this study from February 2014 to December 2015. After exclusion according to defined criteria, 161 patients were incorporated into the final analysis. Selective catheterization of the bilateral subclavian artery and the bilateral common carotid artery were conducted successfully in all patients, and the success rate of selective catheterization of the left vertebral artery was 82.0%. The success rate of the left vertebral artery catheterization was positively correlated with the angle between the left vertebral artery and the left subclavicular artery (P < 0.001), with 90 degrees serving as a demarcation point, and this was higher in patients without innominate artery distortion (90.2-75.0%), although this finding was not statistically significant. However, the morphology of the aortic artery did not affect the success rate of selective catheterization of the left vertebral artery (P = 0.189), and there was no significant difference (P = 0.231) in the success rate of selective catheterization if the left vertebral artery was predominant (91.0%, 81/89) or balanced (84.7%, 61/72). A total of 0.9% (2/161) of the patients experienced surgery-related complications. Both these patients exhibited bleeding at the puncture point when they were deflated 2 hr after the operation. They were pressurized and depressurization was again conducted for an appropriate period of time.Conclusions: The angle between the left vertebral artery and the left subclavicular artery is the primary vessel-associated morphological factor affecting the success rate of selective catheterization of the left vertebral artery in the right-sided radial artery cerebral angiography, while innominate artery distortion also had some more limited impact on this success rate.