桡动脉入路全脑血管造影的影响因素研究

Influence Factors of Cerebral Angiography via Trans-radial Approach

目的探讨分析桡动脉入路全脑血管造影的影响因素。方法采用回顾性病例对照研究,连续登记2014年1-12月在首都医科大学附属北京潞河医院神经内科收治的桡动脉入路全脑血管造影患者293例,收集患者人口学资料、血管危险因素、主动脉弓及变异、成攀技术方式、手术操作时间及并发症。依据手术操作时间分为手术困难组和对照组,通过两组间差异及多因素Logistic回归分析影响手术难度的相关因素。结果 293例患者中,男212例,女81例,平均年龄(63.3±9.8)岁。手术困难组和对照组比较发现,年龄、糖尿病、高血压、高脂血症、吸烟史、Ⅲ型主动脉弓差异有统计学意义。Logistic回归分析发现,Ⅲ型主动脉弓(比值比9.93,95%可信区间6.63～14.86,P<0.01)是影响桡动脉入路全脑血管造影手术难度的独立危险因素。结论主动脉弓形态是影响经桡动脉全脑血管造影的重要因素,Ⅲ型主动脉弓使造影难度增加、并发症增多。

Objective To explore the influence factors and predictors of whole cerebral angiography via transradial approach.Methods A total of 293 patients who underwent whole cerebral angiography via trans-radial approach from January 2014 to December 2014 were consecutively included in this retrospective case-control study. The data of general demography, vascular risk factors, aortic arch type, operation time of angiography and perioperative complications were collected. According to the operation time, the patients were divided into difficult operation group and control group. Multifactor Logistic regression analysis was used to find out the influence factors and predictors of whole cerebral angiography via trans-radial approach.Results There were 293 cases in all, with 212 males and the mean age of（63.3±9.8） years. Comparing the data of both groups, the results showed that there were significant different in the age, diabetes, hypertension, hyperlipemia, history of smoking, Myla Ⅲ aortic arch between the two groups. Logistic regression analysis was used to show that and Myla Ⅲ aortic arch（odds ratio 9.93, 95% confidence interval 6.63-14.86, P〈0.01） was an independent risk factor of cerebral angiography via trans-radial approach.Conclusions Aortic arch type is an important influence factor for cerebral angiography via trans-radial approach. There were more difficulties and perioperative complications for cerebral angiography via trans-radial approach in patients with Myla Ⅲ aortic arch.