经桡动脉途径行全脑血管造影的可行性与安全性研究

Analysis on feasibility and safety of transradial cerebral angiograpy

目的：探讨经桡动脉途径行全脑血管造影的可行性、安全性及有效性。方法2012年6月-2013年10月经桡动脉途径行全脑血管造影检查165例（桡动脉组），同期经股动脉途径行全脑血管造影183例（股动脉组），对其临床资料进行回顾分析。对两组患者的穿刺时间、穿刺成功率、手术操作时间、造影剂剂量、造影成功率、术后恢复时间及总并发症发生率进行统计分析。结果两组患者中桡动脉组有2例穿刺失败，改为股动脉途径完成造影，其他患者均顺利完成造影。两组患者的平均穿刺时间、穿刺成功率、手术操作时间、造影剂剂量、造影成功率，桡动脉组分别为（2.3±1.2）min、98.8%（163/165）、（30.32±7.23）min、（63±13）ml、98.8%（163/165），股动脉组分别为（2.1±0.9）min、100%（183/183）、（28.95±8.21）min、（61±11）ml、100%（183/183），两组间比较差异均无统计学意义（P值均〉0.05）。桡动脉组术后恢复时间为（5.6±2.3）h、总并发症的发生率1.2%（2/163），股动脉组术后恢复时间为（23.8±4.2）h、总并发症的发生率10.4%（19/183），两组间比较，差异均有统计学意义（P值均〈0.05）。结论经桡动脉途径行全脑血管造影术安全、有效，患者痛苦小、易接受，并发症发生率低，术后恢复快，可作为脑血管造影的常用途径之一。

Objective To explore the feasibility, efficacy and safety of transradial approach to cerebral angiography. Methods From Jun. 2012 to Oct. 2013, a total of 165 cerebral angiographies were performed via a transradial approach, 183 transfemoral cerebral angiography as control. The puncture time, the success rate of puncture, the time of procedure, the dosage of contrast media, the rate of success, the rate of total complications and the recovery time were compared between two groups. Results The operation failed in 2 cases in transradial group changed to transfemoral approach to complete cerebral angiography, other patients were successfully performed. The average time of puncture, the success rate of puncture, the time of procedure, the dosage of contrast media and the rate of success in transradial cerebral angiography were（2.3±1.2）min,98.8%（163/165）,（30.32±7.23）min,（63±13）mland98.8%（163/165） , respectively. The same measures in transfemoral cerebral angiography were（2. 1 ± 0. 9） min, 100%（183/183）,（28. 95 ± 8. 21）min, （61 ± 11）ml and 100%（183/183）, respectively. There were no significant differences between two groups（all P values 〉0. 05）. The recovery time after procedure and the total complications rate in transradial cerebral angiography group were （5. 6 ± 2. 3h） and 1. 2% （2/163）, respectively. The same measures in transfemoral cerebral angiography were （23. 8 ± 4. 2h）and 10. 4%（19/183）, respectively. The recovery time after procedure were significantly superior to those of transfemoral group, the complication rate was obviously lower in transradial approach group than that in transfemoral approach group（all P values〈0. 05）. Conclusions This study suggests that cerebral angiography using a transradial approach can be performed with minimal risk of morbidity and more utility. In particular, this procedure might be useful to decrease complication and lessen patient′s discomfort and stress, and it is easy to be accepted, transradial cerebral angiography is worth using generally.