桡动脉远端入路治疗颅内动脉瘤98例的单中心研究

A Single-center Study of 98 Patients with Intracranial Aneurysm Treated by Distal Radial Artery Approach

目的探究桡动脉远端入路治疗颅内动脉瘤98例的有效性及安全性。方法回顾性分析2018年1月~2022年9月在本院行桡动脉远端入路介入治疗的98例颅内动脉瘤患者临床资料,分析全部患者手术中导管到达位置、手术成功情况及并发症发生情况。结果98例患者中有47例患者为前循环动脉瘤,51例患者为后循环动脉瘤,均成功完成手术,术中导管均到位。其中2例患者椎动脉迂曲严重,最终在左侧椎动脉V1段将导引导管置入;1例患者患侧左椎动脉纤细,最终通过翻山技术选择右侧桡动脉远端入路。术后3例(3.06%)患者出现血管痉挛,均在用药后得到缓解。术后5例(5.10%)患者出现术侧手肿胀,3例(3.06%)患者出现穿刺处皮下瘀血,均自行缓解。术后全部患者均未出现假性动脉瘤等严重并发症。术后1周超声显示全部患者桡动脉血流通畅。结论桡动脉远端入路治疗颅内动脉瘤的技术成功率及安全性较高,可为临床颅内动脉瘤介入治疗入路选择提供参考。

Objective To investigate the efficacy and safety of distal radial artery approach in treating 98 cases of intracranial aneurysms.Methods The clinical data of 98 patients with intracranial aneurysms who underwent distal radial artery interventional therapy in our hospital from January 2018 to September 2022 were retrospectively analyzed,and the location of catheter arrival,the success of operation and the occurrence of complications in all patients were analyzed.Results Among the 98 patients,47 patients had anterior circulation aneurysms and 51 patients had posterior circulation aneurysms.All of them were successfully operated with catheters in place.Two of the patients had severe vertebral artery tortuosity,and finally the guiding catheter was placed in the left vertebral artery V1 segment.In one patient,the left vertebral artery on the affected side was thin,and a distal approach to the right radial artery was finally selected by mountain-turning technique.Postoperative vasospasm occurred in 3 patients(3.06%),all of which were relieved after medication.Postoperative hand swelling occurred in 5 patients(5.10%)and subcutaneous stasis at the puncture site in 3 patients(3.06%),all of which were resolved by themselves.No serious complications such as false aneurysm occurred in all patients.One week after operation,ultrasound showed that radial artery flow was patency in all patients.Conclusion The technique success rate and safety of distal radial artery approach in the treatment of intracranial aneurysms are high,which can provide reference for the selection of clinical interventional approach for intracranial aneurysms.