经桡动脉途径行全脑血管造影的临床应用

The clinical application of the transradial approach for selective cerebral angiography

目的评价经桡动脉行全脑血管造影的安全性及有效性，探讨其技术要点、主要优缺点及适应证、禁忌证。方法对52例不适合经股动脉途径造影或不愿意术后卧床的患者进行经桡动脉全脑血管造影检查（桡动脉组），统计其穿刺成功率、造影成功率及并发症发生率。并与同期进行的83例经股动脉全脑血管造影（股动脉组）结果进行比较。数据分析采用）（2检验。结果两组患者的穿刺成功率、造影成功率及并发症发生率在桡动脉组分别为96．2％（50／52）、94．2％（49／52）、9．6％（5／52），股动脉组分别为100％（83／83）、95．2％（79／83）、8．4％（7／83），两者差异无统计学意义（X^2值均为0．000，P值均〉0．05）。桡动脉组患者发生穿刺部位轻微淤血2例，无血肿、假性动脉瘤和动静脉瘘等严重并发症发生。结论经桡动脉途径选择性全脑血管造影术安全有效，患者痛苦小、并发症发生率低，可作为脑血管造影的选择途径之一。

Objective To evaluate the feasibility and safety of transradial cerebral angiography and to discuss the technique points, advantages, disadvantages, indication and contraindication. Methods Transradial cerebral angiography was performed in 52 patients who were not suitable for transfemoral access or could not suffer from being kept in bed for 24 hours after transfemoral angiography, related complications and success rate of puncture and selective angiography were recorded and compared with transfemoral group （n = 83 ）. Chi-square test was used for statistics. Results The success rate of puncture and selective angiography and the complication rate of transradial and transfemoral groups were 96. 2% （50/52） ,94. 2% （ 49/52 ） ,9. 6% （ 5/52 ） and 100% （ 83/83 ） , 95.2% （ 79/83 ） , 8. 4% （ 7/83 ） , respectively. There were no significant differences between two groups （ X^2 = 0. 000, P 〉 0. 05 ） . After angiography, 2 patients of transradial group developed a mild bruise at the puncture site, no hematoma, pseudoaneurysm and arteryvenous fistula occurred. Conclusion Transradial selective cerebral angiography is technically feasible and safe with comfortable and minimal complications. It should be used as the choice of routes for selective cerebral angiography.