桡动脉穿刺失败后经同侧尺动脉途径行外周血管介入的安全性与可行性

The safety and feasibility of peripheral vascular intervention via the ipsilateral transulnar access due to failure of transradial artery puncture

目的 探讨桡动脉穿刺插管(TRA)失败后经同侧尺动脉穿刺插管(TUA)行外周血管介入的安全性与可行性。方法 回顾性分析了我院2019年1月至2021年12月TRA外周血管介入手术2 546例次,TRA失败共计37例次,其中转换成同侧TUA 27例次,对TRA失败后同侧TUA的穿刺成功率、手术成功率及穿刺入路相关并发症予以分析。结果 TRA失败后同侧TUA的成功率为96.3%(26/27),1例因发生尺动脉痉挛而转换成股动脉入路。总的手术成功率为96.3%(26/27)。无严重并发症发生,轻微并发症发生率为19.2%(5/26)。结论 初步结果表明,对有一定经验的TRA操作者,TRA失败后转换为同侧TUA是一种安全、可行的策略选择。

Objective To investigate the safety and feasibility of peripheral vascular intervention via the ipsilateral transulnar access(TUA)due to failure of transradial access(TRA)puncture.Methods The clinical data of 2546 peripheral vascular interventions via TRA,which were performed at authors’hospital between January 2019 and December 2021,were retrospectively analyzed.Among the 2546 interventions,TRA puncture failed in 37 procedures,and in 27 of these patients the ipsilateral TUA puncture had to be adopted.The puncture success rate,surgical success rate and puncture approach-related complications of TUA of the 27 patients receiving ipsilateral TUA puncture were analyzed.Results The success rate of ipsilateral TUA puncture after TRA puncture failed was 96.3%(26/27),and in one patient transfemoral access(TFA)puncture had to be substituted because of the ulnar artery spasm.The total success rate of interventional procedures was 96.3%(26/27).No serious complications occurred,and the incidence of minor complications was 19.2%(5/26).Conclusion Preliminary results indicate that for the experienced TRA operators,using ipsilateral TUA puncture due to failure of TRA puncture is a safe and feasible strategy choice.