Distal Radial Artery Access for Superficial Femoral Artery Interventions.
Distal Radial Artery Access for Superficial Femoral Artery Interventions.
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DOI：
10.1177/1526602820963022
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Merkely B
中科院分区：
文献类型：
--
作者：
Ruzsa Z;Csavajda Á;Nemes B;Deák M;Sótonyi P;Bertrand OF;Merkely B
目的比较经桡动脉远端(DR)和近端(PR)行股浅动脉(SFA)介入治疗的急性成功率和并发症发生率。2016年至2019年间，连续195例有症状的SFA狭窄患者使用无套导管通过DR(n=38)或PR(n=157)途径进行治疗。必要时可通过踏板动脉进行二次探查。主要结果是技术上的成功、主要不良事件(MAE)和通路部位的并发症。次要结果是治疗成功率、透视时间、放射剂量、手术时间和到另一个穿刺点的交叉率。188名患者(96.4%)总体技术成功：DR组38名患者中37名(97.3%)，PR组157名患者中151名(96.2%)(p=0.9)。DR组14例(36.8%)和PR组28例(18.9%)采用双侧(经桡和经椎弓根)入路(p<；0.01)。26例DR患者中25例(96.1%)和81例PR患者中79例(92.6%)慢性完全闭塞再通(p=0.57)。DR组与PR组的股骨头交叉率分别为0%和3.2%(p=0.59)。DR组15例(39.4%)和PR组39例(24.8%)在SFA置入支架(p=0.1)。DR组和PR组的对比度、透视时间、辐射剂量和手术时间无统计学差异，入路部位并发症发生率(分别为2.6%和7.0%)也无统计学差异。6个月时DR组和PR组MAE累积发生率分别为15.7%和14.6%(P=0.8)。使用PR或DR途径可以安全有效地实施SFA干预，并具有可接受的发病率和高技术成功率。DR访问与访问站点的并发症很少相关。
To compare the acute success and complication rates of distal radial (DR) vs proximal radial (PR) artery access for superficial femoral artery (SFA) interventions. Between 2016 and 2019, 195 consecutive patients with symptomatic SFA stenosis were treated via DR (n=38) or PR (n=157) access using a sheathless guide. Secondary access was achieved through the pedal artery when necessary. The main outcomes were technical success, major adverse events (MAEs), and access site complications. Secondary outcomes were treatment success, fluoroscopy time, radiation dose, procedure time, and crossover rate to another puncture site. Overall technical success was achieved in 188 patients (96.4%): 37 of 38 patients (97.3%) in the DR group and 151 of 157 patients (96.2%) in the PR group (p=0.9). Dual (transradial and transpedal) access was used in 14 patients (36.8%) in the DR group and 28 patients (18.9%) in the PR group (p<0.01). Chronic total occlusions were recanalized in 25 of 26 DR patients (96.1%) and in 79 of 81 PR patients (92.6%) (p=0.57). The crossover rate to femoral access was 0% in the DR group vs 3.2% in the PR group (p=0.59). Stents were implanted in the SFA in 15 DR patients (39.4%) and in 39 patients (24.8%) in the PR group (p=0.1). The contrast volume, fluoroscopy time, radiation dose, and procedure time were not statistically different between the DR and PR groups, nor were the rates of access site complications (2.6% and 7.0%, respectively). The cumulative incidences of MAE at 6 months in the DR and PR groups were 15.7% vs 14.6%, respectively (p=0.8). SFA interventions can be safely and effectively performed using PR or DR access with acceptable morbidity and a high technical success rate. DR access is associated with few access site complications.
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影响因子：
4.3
作者：
Alvarez-Tostado, Javier A.;Moise, Mireille A.;Kashyap, Vikram S.
通讯作者：
Kashyap, Vikram S.
影响因子：
2.3
作者：
Ruzsa, Z.;Toth, K.;Merkely, B.
通讯作者：
Merkely, B.
影响因子：
5.9
作者：
Gutzeit, A.;Graf, N.;Binkert, C. A.
通讯作者：
Binkert, C. A.
影响因子：
6.2
作者：
Kiemeneij, Ferdinand
通讯作者：
Kiemeneij, Ferdinand
影响因子：
11.3
作者：
Ruzsa, Zoltan;Bellavics, Robert;Merkely, Bela
通讯作者：
Merkely, Bela