Radial Artery Catheterization for Neuroendovascular Procedures Clinical Outcomes and Patient Satisfaction Measures
Radial Artery Catheterization for Neuroendovascular Procedures Clinical Outcomes and Patient Satisfaction Measures
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DOI：
10.1161/strokeaha.119.025811
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发表时间：
2019-09-01
期刊：
影响因子：
8.3
通讯作者：
Jabbour, Pascal M.
中科院分区：
文献类型：
--
作者：
Khanna, Omaditya;Sweid, Ahmad;Jabbour, Pascal M.
背景和目的-桡动脉导管插入术是一种替代入路，已开始更广泛地用于神经血管内手术，很少有研究描述其安全性和有效性。我们介绍了我们机构通过经桡动脉途径进行神经血管内介入治疗的经验，具有良好的临床结局和患者满意度。方法：我们进行了回顾性分析，确定了在我们机构接受了233次经桡动脉入路的连续神经血管内介入治疗的223例患者。研究围手术期和术后并发症的发生率。我们确定了98例接受经桡动脉和经股动脉脑血管造影的患者，并比较了两组之间的临床结局和患者满意度。结果-所有经桡动脉入路手术的并发症总发生率较低。围手术期，仅2例患者出现症状性桡动脉痉挛，无医源性并发症（血管夹层、卒中和出血）。在10例病例（4.3%）中，无法通过经桡动脉入路完成预期手术，因此，不得不改为股动脉入路。10例患者主诉轻微术后并发症，但均不需要治疗干预。经桡动脉穿刺与经股动脉穿刺进行诊断性血管造影的平均手术时间更短（18.8 +/- 15.8 vs 39.5 +/- 31.1分钟; P=0.025）。总体而言，患者报告经桡动脉入路的恢复时间较短，大多数患者（94%）将选择通过该途径进行后续手术。结论：桡动脉导管插入术是一种安全、耐用的替代方法，可用于各种神经血管内手术，并发症发生率低。总的来说，与经股动脉入路相比，患者更喜欢经桡动脉入路。
Background and Purpose- Radial artery catheterization is an alternate route of access that has started to gain more widespread use for neuroendovascular procedures, and there have been few studies that describe its safety and efficacy. We present our institution's experience in performing neuroendovascular interventions via a transradial approach, with excellent clinical outcomes and patient satisfaction measures. Methods- We conducted a retrospective analysis and identified 223 patients who underwent 233 consecutive neuroendovascular interventions via radial artery access at our institution. The incidence of perioperative and postprocedural complications was investigated. We identified a subset of 98 patients who have undergone both transradial and transfemoral cerebral angiograms and compared clinical outcomes and patient satisfaction measures between the 2 groups. Results- The overall incidence of complications was low across all procedures performed via transradial access. Peri-procedurally, only 2 patients had symptomatic radial artery spasm, and there were no instances of iatrogenic complications (vessel dissection, stroke, and hemorrhage). In 10 cases (4.3%), the intended procedure could not be completed via a transradial approach, and, thus, femoral artery access had to be pursued instead. Ten patients complained of minor postprocedural complications, although none required therapeutic intervention. The mean procedure time was shorter for diagnostic angiograms performed via transradial versus transfemoral access (18.8 +/- 15.8 versus 39.5 +/- 31.1 minutes; P=0.025). Patients overall reported shorter recovery times with transradial access, and the majority of patients (94%) would elect to have subsequent procedures performed via this route. Conclusions- Radial artery catheterization is a safe and durable alternative to perform a wide range of neuroendovascular procedures, with a low rate of complications. On the whole, patients prefer transradial compared with transfemoral access.