持续动脉压监测对经桡动脉入路脑血管造影术中导管扭转打结的预防价值

The value of continuous arterial pressure monitoring in preventing the catheter kinking and knotting during cerebral angiography via transradial access

目的探讨经桡动脉入路脑血管造影中持续动脉压监测在发现导管扭转打结中的作用。方法回顾性分析2017年7月至2019年12月接受经桡动脉入路脑血管造影的116例缺血性脑血管病患者的临床病例资料,其中80例造影过程中接受持续动脉压监测(测压组),另36例作为无测压组。在操作过程中,动脉压力差变小甚至曲线变平提示导管某段发生扭转打结。比较两组患者的性别、年龄、主动脉弓型等基本临床病例信息,手术适应证、透视时间、手术时间,以及造影过程中导管扭转打结发生率。结果两组患者性别、年龄、主动脉弓型、透视时间、手术时间差异均无统计学意义。测压组动脉导管扭转打结发生率低于无测压组(0 vs 8.33%,P=0.047)。结论持续动脉压力监测有助于发现早期桡动脉入路脑血管造影过程中导管扭转打结,进而降低相关并发症的发生,值得推广应用。

Objective To investigate the role of continuous arterial pressure monitoring in discovering catheter kinking and knotting in cerebral angiography via transradial access.Methods A retrospective analysis was performed in 116 patients with ischemic cerebrovascular disease who underwent cerebral angiography via transradial access between July 2017 and December 2019.Of them,36 patients were completed using the traditional connecting catheter method,and 80 patients received cerebral angiography under continuous arterial pressure monitoring(pressure-monitoring group),other 36 patients were as non-pressure-monitoring group.It indicated that a certain segment of the catheter kinked or knotted when pressure difference of arterial pressure becomes smaller during the operation.The gender,age,aortic arch type,and other basic clinical and pathological information,and the surgical indications,fluoroscopy time,and operation time,and incidence of catheter kinking and knotting were compared in patients between the two groups.Results There was no significant difference in gender,age,aortic arch type,fluoroscopy time,and operation time between the two groups.The incidence of catheter kinking and knotting in the pressure-monitoring group was significantly lower than that in the non-pressure-monitoring group(0 vs 8.33%,P=0.047).Conclusions During cerebral angiography via transradial access,continuous artery pressure monitoring is helpful to discover catheter kinking and knotting,and reduces related complications rates,which is worthy of further promotion and application.