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Abstract：
BACKGROUND The transradial approach (TRA) for cerebral angiography and neurointerventional treatment has gained popularity, but the narrow diameter and weak pulsation of the radial artery lower the initial puncture success rate compared to femoral artery puncture. This retrospective study from a single center evaluated the incidence of and factors associated with radial artery occlusion (RAO) in 543 patients who underwent transradial approach (TRA) for cerebral angiography. MATERIAL AND METHODS We included 543 patients who underwent TRA from July 2021 to February 2024. Ultrasound was used to determine whether the radial artery was occluded. Relevant clinical data were recorded to assess the incidence of and factors affecting RAO. RESULTS At 24 h after DSA, we performed ultrasound imaging. The patients were divided into an RAO group (n=32) and a non-RAO group (n=511). Results showed that RAO was significantly higher in patients who did not have add heparin to the antispasmodic agents, and they were more likely to have needed more than 3 radial artery puncture attempts, and tended to have received an 11-cm radial artery sheath with the Cordis puncture needles (all P<0.05). Multiple regression logistic analysis showed that adding heparin to the antispasmodic agents (OR=0.076, 95% CI: 0.018-0.321, P<0.001), having fewer than 3 radial artery puncture attempts (OR=0.245, 95% CI: 0.111-0.541, P<0.001), using a 16-cm radial artery sheath (OR=0.195, 95% CI: 0.067-0.564, P=0.003), and using Terumo puncture needles (OR=0.325, 95% CI: 0.148-0.717, P=0.005) can reduce the incidence of radial artery occlusion. CONCLUSIONS Our center found that adding heparin to the antispasmodic agents reduced the number of radial artery punctures attempts, and using a 16-cm radial artery sheath significantly lowered the incidence of early RAO after transradial cerebral angiography.
摘要：
背景技术用于脑血管造影和神经介入治疗的经桡动脉入路(TRA)已获得普及,但是与股动脉穿刺相比，桡动脉的狭窄直径和弱搏动降低了初始穿刺成功率。这项来自单个中心的回顾性研究评估了543例经桡动脉入路（TRA）进行脑血管造影的患者中桡动脉闭塞（RAO）的发生率和相关因素。材料与方法我们纳入了2021年7月至2024年2月接受TRA的543例患者。超声用于确定桡动脉是否闭塞。记录相关临床资料以评估RAO的发生率和影响因素。结果在DSA后24小时，我们进行了超声成像。患者分为RAO组（n=32）和非RAO组（n=511）。结果显示，RAO在没有添加肝素的抗痉挛药的患者中明显更高，他们更有可能需要三次以上的桡动脉穿刺尝试，并且倾向于使用Cordis穿刺针接受11厘米的桡动脉鞘（均P<0.05）。多因素logistic回归分析显示抗痉挛药中加入肝素(OR=0.076,95%CI:0.018～0.321,P<0.001),少于3次桡动脉穿刺尝试（OR=0.245，95％CI：0.111-0.541，P<0.001），使用16厘米的桡动脉鞘（OR=0.195，95％CI：0.067-0.564，P=0.003），使用Terumo穿刺针（OR=0.325，95％CI：0.148-0.717，P=0.005）可以降低桡动脉闭塞的发生率。结论我们的中心发现，在抗痉挛药物中加入肝素可减少桡动脉穿刺尝试的次数，使用16厘米的桡动脉鞘显着降低了经桡动脉脑血管造影后早期RAO的发生率。
