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Abstract：
OBJECTIVE: To evaluate the clinical efficacy of digital subtraction angiography (DSA) performed via femoral artery and radial artery approaches.
METHODS: This retrospective study included 480 patients requiring cerebral vascular angiography at the First People\'s Hospital of Changde City from March 2020 to February 2022. Patients were divided into the femoral artery group (transfemoral approach, n=400) and the radial artery group (transradial approach, n=80) according to the surgical route. We compared perioperative metrics, success rates of selective angiography and puncture, and complication rates (including pseudoaneurysm, urinary retention, hematoma, vasospasm) between the groups. Multivariate logistic regression was used to analyze factors influencing the failure of angiography by each approach.
RESULTS: The radial artery group exhibited shorter durations for puncture, hemostasis, exposure, operation, and postoperative recovery (all P<0.001). The success rate of selective angiography was higher in the radial artery group (93.75%) compared to the femoral artery group (85.25%) (χ2=4.168, P=0.041). No significant difference was found in puncture success rates between the groups (χ2=0.235, P=0.628). The overall complication rate was significantly lower in the radial artery group (2.50%) compared to the femoral artery group (9.25%) (χ2=4.069, P=0.044). Gender and low-density lipoprotein cholesterol levels were significant predictors of angiography failure in both approaches (both P<0.05).
CONCLUSIONS: The transradial approach for DSA is safe and feasible, offering advantages in terms of operational time and complication rates, making it the preferred method in clinical settings.
METHODS: This retrospective study included 480 patients requiring cerebral vascular angiography at the First People\'s Hospital of Changde City from March 2020 to February 2022. Patients were divided into the femoral artery group (transfemoral approach, n=400) and the radial artery group (transradial approach, n=80) according to the surgical route. We compared perioperative metrics, success rates of selective angiography and puncture, and complication rates (including pseudoaneurysm, urinary retention, hematoma, vasospasm) between the groups. Multivariate logistic regression was used to analyze factors influencing the failure of angiography by each approach.
RESULTS: The radial artery group exhibited shorter durations for puncture, hemostasis, exposure, operation, and postoperative recovery (all P<0.001). The success rate of selective angiography was higher in the radial artery group (93.75%) compared to the femoral artery group (85.25%) (χ2=4.168, P=0.041). No significant difference was found in puncture success rates between the groups (χ2=0.235, P=0.628). The overall complication rate was significantly lower in the radial artery group (2.50%) compared to the femoral artery group (9.25%) (χ2=4.069, P=0.044). Gender and low-density lipoprotein cholesterol levels were significant predictors of angiography failure in both approaches (both P<0.05).
CONCLUSIONS: The transradial approach for DSA is safe and feasible, offering advantages in terms of operational time and complication rates, making it the preferred method in clinical settings.
摘要：
目的：评价经股动脉和桡动脉入路数字减影血管造影（DSA）的临床疗效。
方法：本回顾性研究纳入2020年3月至2022年2月常德市第一人民医院行脑血管造影的480例患者。患者分为股动脉组(经股动脉入路，n=400）和桡动脉组（经桡动脉入路，n=80)根据手术途径。我们比较了围手术期指标，选择性血管造影和穿刺的成功率，和并发症发生率（包括假性动脉瘤，尿潴留,血肿,血管痉挛）。采用多因素logistic回归分析各途径血管造影失败的影响因素。
结果：桡动脉组的穿刺时间较短，止血,暴露,操作,术后恢复情况(均P<0.001)。桡动脉组选择性血管造影成功率(93.75%)高于股动脉组(85.25%)(χ2=4.168,P=0.041)。两组穿刺成功率比较差异无统计学意义(χ2=0.235,P=0.628)。桡动脉组的总并发症发生率（2.50％）明显低于股动脉组（9.25％）（χ2=4.069，P=0.044）。性别和低密度脂蛋白胆固醇水平是两种方法中血管造影失败的重要预测因素（均P<0.05）。
结论：经桡动脉途径DSA是安全可行的，在手术时间和并发症发生率方面具有优势，使其成为临床环境中的首选方法。
方法：本回顾性研究纳入2020年3月至2022年2月常德市第一人民医院行脑血管造影的480例患者。患者分为股动脉组(经股动脉入路，n=400）和桡动脉组（经桡动脉入路，n=80)根据手术途径。我们比较了围手术期指标，选择性血管造影和穿刺的成功率，和并发症发生率（包括假性动脉瘤，尿潴留,血肿,血管痉挛）。采用多因素logistic回归分析各途径血管造影失败的影响因素。
结果：桡动脉组的穿刺时间较短，止血,暴露,操作,术后恢复情况(均P<0.001)。桡动脉组选择性血管造影成功率(93.75%)高于股动脉组(85.25%)(χ2=4.168,P=0.041)。两组穿刺成功率比较差异无统计学意义(χ2=0.235,P=0.628)。桡动脉组的总并发症发生率（2.50％）明显低于股动脉组（9.25％）（χ2=4.069，P=0.044）。性别和低密度脂蛋白胆固醇水平是两种方法中血管造影失败的重要预测因素（均P<0.05）。
结论：经桡动脉途径DSA是安全可行的，在手术时间和并发症发生率方面具有优势，使其成为临床环境中的首选方法。
