Applications of Transradial Approach for Endovascular Interventions <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

李晓光　　杨　宁　　潘　杰
刘　巍　　孙革利　　金征宇
中国医学科学院中国协和医科大学北京协和医院放射科 北京 100730

Xiao-guang Li, Ning Yang, Jie Pan, Wei Liu, Ge-li Sun, Zheng-yu Jin
Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China

ABSTRACT

Objective：To evaluate the applications of transradial approach for endovascular interventions and to discuss the technical key points, indications, contraindications and advantages.
　　Methods：230 patients underwent endovascular interventions via radial artery for 265 times. Technical success rate and related complications were recorded.
　　Results：Out of 265 times of interventions, 260(98.1%) achieved success. No serious complications occurred except 3 local hematomas and during follow-up, weakened palpation of the radial artery in 8 cases and one arterial occlusion occurred,  but without hand ischemia.

Conclusion：Transradial approach for endovascular interventions is feasible and safe, and it has such advantages as high success rate, minimal complications, more comfor and less influence on treatment plan.
　　Key words：Radial artery, Endovascular interventions

　　股动脉是进行血管内介入诊疗操作最常采用的途径，但少数情况下，例如双侧髂股动脉严重狭窄或闭塞、主动脉瘤或夹层、正在接受抗凝或溶栓治疗等，经股动脉途径危险性较大甚至不可能成功，必须采用经锁骨下动脉、腋动脉或肱动脉等顺行插管途径。这些动脉周围均有重要的神经和静脉伴行，穿刺插管有发生严重并发症的可能，技术难度也较大，另外由于术后需要较长时间制动，患者常感到很不舒适。为此，笔者尝试经桡动脉途径进行血管内介入诊疗操作，取得了满意效果，现报告如下。 

资料与方法

一、一般资料 

2000.02～2004.01共对230例患者(男122例，女108例，年龄17～88岁，平均62.4岁)经桡动脉途径进行血管内介入诊疗操作265例次。原发病变包括下肢动脉狭窄或闭塞105例、颈动脉狭窄6例、原发性肝癌52例、胆管癌12例、肝转移癌15例、肝海绵状血管瘤6例、胰腺癌10例、肾动脉狭窄4例、大动脉炎3例、主动脉夹层5例、腹主动脉瘤12例。主要介入诊疗操作包括下肢动脉造影120例次、颈动脉造影6例次、腹部动脉造影及化疗栓塞119例次、主动脉造影20例次。共30例患者接受了同侧桡动脉的多次插管，其中3次者5例、2次者25例。