经桡动脉途径行外周血管介入的临床研究

Clinical study of peripheral vascular intervention via radial artery

目的评价经桡动脉途径(TRA)行外周血管介入的安全性和可行性。方法回顾性收集2017年9月至2019年3月于中国医学科学院肿瘤医院TRA行外周血管介入治疗的106例肿瘤患者的临床资料,分析患者的桡动脉穿刺率、穿刺完成后续操作的手术成功率以及术后30 d内相关并发症。结果106例患者中,TRA外周血管介入操作112例次,其中行经导管肝动脉化疗栓塞术83例次,支气管动脉灌注术4例次,盆腔肿瘤栓塞术11例次,其他手术14例次。所有介入操作穿刺成功率为97.3%(109/112),手术成功率为98.2%(107/109)。5例患者TRA失败,转为股动脉穿刺,并顺利完成操作。手术严重并发症为主动脉夹层2例次;轻微并发症中,桡动脉闭塞2例次,桡动脉痉挛1例次,手臂疼痛1例次,穿刺点血肿1例次。严重并发症和轻微并发症发生率分别为1.8%(2/112)和4.5%(5/112)。急诊操作16例次,均顺利完成操作,无并发症发生。结论TRA行外周血管介入治疗是安全、可行的。

Objective To discuss the safety and feasibility of transradial access(TRA)in performing peripheral arterial intervention.Methods The clinical data of the patients underwent peripheral vascular intervention via TRA in our hospital from September 2017 to March 2019 were reviewed.The success rate of radial artery puncture and subsequent operation after puncture,and related postoperative complications within 30 days were analyzed.Results The clinical data of 112 peripheral arterial intervention procedures via TRA performed on 106 patients were reviewed,including transcatheter arterial chemoembolization in 83 cases,bronchial arterial infusion in 4 cases,pelvic tumor embolization in 11 cases and 14 other cases.The success rate of all interventional punctures was 97.3%(109/112),the operative success rate of interventional procedures was 98.2%(107/109).The TRA operation was failed in 5 patients,who were then converted to receive the femoral artery puncture and complete successfully.The severe complication of the operation was aortic dissection(2 cases).Minor complications included 2 cases of radial artery occlusion,radial artery spasm,arm pain and puncture point hematoma for each case.The severe complication and the minor complication rates were 1.8%(2/112)and 4.5%(5/112),respectively.Sixteen emergency operations were performed successfully,and no complication occurred.Conclusion The TRA is a clinically safe and feasible approach for peripheral arterial interventional procedure.