Back hand approach to radial access: The snuff box approach
Back hand approach to radial access: The snuff box approach
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DOI：
10.1016/j.carrev.2017.08.014
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发表时间：
2018-04-01
影响因子：
1.7
通讯作者：
Gilchrist, Ian C.
中科院分区：
文献类型：
--
作者：
Davies, Rhian E.;Gilchrist, Ian C.
经桡动脉入路正成为常规冠状动脉手术的默认策略，但仍有改进的空间。例如，已知左桡动脉入路为移植物病例提供了一些优势、较少的迂曲度以及其他潜在益处。缺点是从患者和操作者的角度来看，该接入点对具有较大体重指数的患者的适用性。患者必须以仰卧位躺下，因此操作员必须以屈曲位站立一段时间。此外，患有各种骨科损伤（包括冻结肩）的患者可能无法旋后手腕以获得最佳入路。解决这一难题的一种方法是从手背接近桡动脉，这样如果体型要求手臂朝向操作者移动，手腕可以自然地内旋。本报告概述了这种方法背后的步骤和背景，以及为那些有兴趣扩大其访问技能的人提供的教育机会。爱思唯尔公司出版
Transradial access is becoming the default strategy for routine coronary procedures, but there is still room for improvement. For instance, left radial access is known to offer some advantages for graft cases, less tortuosity, amongst other potential benefits. The downside has been the applicability of this access point on patients with a larger body mass index both from the viewpoint of the patient and the operator. The patient must lay with their arm in a supine position and the operator as a result must stand in a flexed position for an unknown period of time. Additionally, patients with various orthopedic injuries, including frozen shoulders, on may be unable to supinate their wrist for optimal access. One solution to this dilemma is to approach the radial artery from the dorsal aspect of the hand so the wrist can pronate naturally if body habitus requires the arm to be shifted towards the operator. This report outlines the steps and background behind this approach and an educational opportunity for those interested in expanding their access skills. Published by Elsevier Inc.