Transradial and Transulnar Access for Iliac Artery Interventions Using Sheathless Guiding Systems: A Feasibility Study
Transradial and Transulnar Access for Iliac Artery Interventions Using Sheathless Guiding Systems: A Feasibility Study
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DOI：
10.1002/ccd.26592
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发表时间：
2016-11-15
影响因子：
2.3
通讯作者：
Merkely, B.
中科院分区：
文献类型：
--
作者：
Ruzsa, Z.;Toth, K.;Merkely, B.
目的：我们的目的是评估使用无鞘引导系统经桡动脉和经尺动脉入路进行髂动脉支架置入术的急性成功率和并发症发生率。方法：对 156 名连续接受经桡动脉或经尺动脉入路治疗的有症状的髂动脉狭窄患者的临床和血管造影数据进行评估。所有患者在干预前后均接受了双重超声检查。主要终点是手术成功率、主要不良事件和穿刺部位并发症发生率。次要终点是髂动脉介入治疗的血管造影结果、透视时间、X射线剂量、手术时间、到另一个穿刺部位的交叉率和住院时间。还研究了学习曲线以及右或左桡动脉通路的影响。结果：干预的适应症为 109 名患者（69.9%）出现间歇性跛行，44 名患者（28.2%）出现严重肢体缺血，3 名患者（1.9%）出现急性肢体缺血。 155 名患者 (99.4%) 取得了技术成功，交叉率为 3.8%。分别有 151 名 (96.8%) 和 7 名 (4.5%) 患者使用了桡动脉和尺动脉入路。由于手术的结果，踝臂指数从 0.69 [0.65-0.72] 增加到 0.91 [0.88-0.95] (P
Purpose: Our aim was to evaluate the acute success and complication rates of the transradial and transulnar access for iliac artery stenting using sheathless guiding systems. Methods: Clinical and angiographic data from 156 consecutive patients with symptomatic iliac artery stenosis who were treated with transradial or transulnar access were evaluated. All patients underwent Duplex ultrasound before and after the intervention. The primary endpoints were the procedural success rate, major adverse events, and access site complication rates. The secondary endpoints were the angiographic result of the iliac artery intervention, fluoroscopy time, X-ray dose, procedure length, crossover rate to another puncture site and hospitalization duration. The impact of the learning curve was also investigated, along with right or left radial access. Results: The indication for the intervention was intermittent claudication in 109 patients (69.9%), critical limb ischemia in 44 (28.2%) subjects and acute limb ischemia in three individuals (1.9%). Technical success was achieved in 155 patients (99.4%), with a crossover rate of 3.8%. Radial and ulnar artery access was used in 151 (96.8%) and 7 (4.5%) patients, respectively. The Ankle-brachial index increased from 0.69 [0.65-0.72] to 0.91 [0.88-0.95] as a result of the procedures (P