切换至 "中华医学电子期刊资源库"

中华介入放射学电子杂志 ›› 2024, Vol. 12 ›› Issue (03) : 261 -266. doi: 10.3877/cma.j.issn.2095-5782.2024.03.012

综述

经桡动脉入路在神经介入的发展与应用
范金铭1, 翁子瑄1, 马武钦1, 周斌1,()   
  1. 1. 中山大学附属第五医院脑血管病中心
  • 收稿日期:2024-01-26 出版日期:2024-08-25
  • 通信作者: 周斌

Development and application of transradial artery access in neurointervention

Jinming Fan1, Zixuan Weng1, Wuqin Ma1, Bin Zhou1,()   

  1. 1. Center of Cerebrovascular Disease, the Fifth Affiliated Hospital of Sun Yat-sen University, Guangdong Zhuhai 519000, China
  • Received:2024-01-26 Published:2024-08-25
  • Corresponding author: Bin Zhou
  • About author:

    Co-first authors: Fan Jinming, Weng Zixuan

引用本文:

范金铭, 翁子瑄, 马武钦, 周斌. 经桡动脉入路在神经介入的发展与应用[J]. 中华介入放射学电子杂志, 2024, 12(03): 261-266.

Jinming Fan, Zixuan Weng, Wuqin Ma, Bin Zhou. Development and application of transradial artery access in neurointervention[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(03): 261-266.

神经介入是在数字减影血管造影系统支持下,经皮穿刺相应血管,采用血管内导管操作技术,对累及神经系统的血管病变进行诊断和治疗的一种新兴微创技术。传统的手术入路是经股动脉入路,后随着经桡动脉入路(transradial access,TRA)在心血管领域的广泛使用以及带来的显著成效,神经介入医师开始思考TRA能否同样适用于神经介入领域。文章综合TRA的进展及其在神经介入领域安全性与可行性的研究与应用,进行一系列归纳总结,并对未来的研究进行展望。

Neurointervention is an emerging minimally invasive technique for the diagnosis and treatment of vascular lesions involving the nervous system by percutaneous puncture of the corresponding blood vessels and the use of intravascular catheterization techniques under the support of digital subtraction angiography (DSA) system. Traditionally, transfemoral access (TFA) has been used. With the widespread use of transradial access (TRA) in the cardiovascular field and the remarkable effect it has brought, neurointerventionists have begun to consider whether TRA can also be applied to the field of neurointervention. In this review, we summarize the literature about the application of TRA and researches assessing its feasibility and safety in the field of neurointervention. Then we propose future directions for this technique.

[1]
Zhou D, Wei D, Xing W, et al. Effects of craniotomy clipping and interventional embolization on treatment efficacy, cognitive function and recovery of patients complicated with subarachnoid hemorrhage[J]. Am J Transl Res, 2021, 13(5): 5117-5126.
[2]
Wiper A, Kumar S, Macdonald J, et al. Day case transradial coronary angioplasty: a four-year single-center experience[J]. Catheter Cardiovasc Interv, 2006, 68(4): 549-553.
[3]
Brueck M, Bandorski D, Kramer W, et al. A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty[J]. JACC Cardiovasc Interv, 2009, 2(11): 1047-1054.
[4]
Campeau L. Percutaneous radial artery approach for coronary angiography[J]. Cathet Cardiovasc Diagn, 1989, 16(1): 3-7.
[5]
Snelling BM, Sur S, Shah SS, et al. Transradial access: lessons learned from cardiology[J]. J Neurointerv Surg, 2018, 10(5): 487-492.
[6]
Rychlik J, Hornacek I, Tejc M, et al. Retrospective analysis of coronary interventions in a single centre and comparison of specific differences between radial and femoral access[J]. Acta Cardiol, 2019, 74(4): 325-330.
[7]
Satti SR, Vance AZ, Golwala SN, et al. Patient preference for transradial access over transfemoral access for cerebrovascular procedures[J]. J Vasc Interv Neurol, 2017, 9(4): 1-5.
[8]
Kühn AL, Satti SR, Eden T, et al. Anatomic snuffbox (distal radial artery) and radial artery access for treatment of intracranial aneurysms with fda-approved flow diverters[J]. AJNR Am J Neuroradiol, 2021, 42(3): 487-492.
[9]
Eid-Lidt G, Rivera Rodríguez A, Jimenez Castellanos J, et al. Distal radial artery approach to prevent radial artery occlusion trial[J]. JACC Cardiovasc Interv, 2021, 14(4): 378-385.
[10]
Koutouzis M, Kontopodis E, Tassopoulos A, et al. Distal versus traditional radial approach for coronary angiography[J]. Cardiovasc Revasc Med, 2019, 20(8): 678-80.
[11]
Lee JW, Park SW, Son JW, et al. Real-world experience of the left distal transradial approach for coronary angiography and percutaneous coronary intervention: a prospective observational study (LeDRA)[J]. EuroIntervention, 2018, 14(9): e995-e1003.
[12]
Liang C, Han Q, Jia Y, et al. Distal transradial access in anatomical snuffbox for coronary angiography and intervention: an updated meta-analysis[J]. J Interv Cardiol, 2021, 2021: 7099044.
[13]
Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI)[J]. EuroIntervention, 2017, 13(7): 851-857.
[14]
Al-Azizi KM, Grewal V, Gobeil K, et al. The left distal transradial artery access for coronary angiography and intervention: a US experience[J]. Cardiovasc Revasc Med, 2019, 20(9): 786-789.
[15]
Bertrand OF, Larose E, Rodés-Cabau J, et al. Incidence, predictors, and clinical impact of bleeding after transradial coronary stenting and maximal antiplatelet therapy[J]. Am Heart J, 2009, 157(1): 164-169.
[16]
Nathan S, Rao SV. Radial versus femoral access for percutaneous coronary intervention: implications for vascular complications and bleeding[J]. Curr Cardiol Rep, 2012, 14(4): 502-509.
[17]
Mahtta D, Manandhar P, Wegermann ZK, et al. Outcomes and institutional variation in arterial access among patients with AMI and cardiogenic shock undergoing PCI[J]. JACC Cardiovasc Interv, 2023, 16(12): 1517-1528.
[18]
Dahm JB, Van Buuren F, Hansen C, et al. The concept of an anatomy related individual arterial access: lowering technical and clinical complications with transradial access in bovine- and type-Ⅲ aortic arch carotid artery stenting[J]. Vasa, 2011, 40(6): 468-473.
[19]
Goland J, Doroszuk GF, Garbugino SL, et al. Transradial approach to treating endovascular cerebral aneurysms: case series and technical note[J]. Surg Neurol Int, 2017, 8: 73.
[20]
Khanna O, Sweid A, Mouchtouris N, et al. Radial artery catheterization for neuroendovascular procedures[J]. Stroke, 2019, 50(9): 2587-2590.
[21]
Mitchell MD, Hong JA, Lee BY, et al. Systematic review and cost-benefit analysis of radial artery access for coronary angiography and intervention[J]. Circ Cardiovasc Qual Outcomes, 2012, 5(4): 454-462.
[22]
Matsumoto Y, Hongo K, Toriyama T, et al. Transradial approach for diagnostic selective cerebral angiography: results of a consecutive series of 166 cases[J]. AJNR Am J Neuroradiol, 2001, 22(4): 704-708.
[23]
Jo KW, Park SM, Kim SD, et al. Is transradial cerebral angiography feasible and safe? A single center's experience[J]. J Korean Neurosurg Soc, 2010, 47(5): 332-337.
[24]
Lee DH, Ahn JH, Jeong SS, et al. Routine transradial access for conventional cerebral angiography: a single operator's experience of its feasibility and safety[J]. Br J Radiol, 2004, 77(922): 831-838.
[25]
Khan NR, Peterson J, Dornbos Iii D, et al. Predicting the degree of difficulty of the trans-radial approach in cerebral angiography[J]. J Neurointerv Surg, 2021, 13(6): 552-558.
[26]
Barros G, Bass DI, Osbun JW, et al. Left transradial access for cerebral angiography[J]. J Neurointerv Surg, 2020, 12(4): 427-430.
[27]
Pacchioni A, Versaci F, Mugnolo A, et al. Risk of brain injury during diagnostic coronary angiography: comparison between right and left radial approach[J]. Int J Cardiol, 2013, 167(6): 3021-3026.
[28]
Zussman BM, Tonetti DA, Stone J, et al. Maturing institutional experience with the transradial approach for diagnostic cerebral arteriography: overcoming the learning curve[J]. J Neurointerv Surg, 2019, 11(12): 1235-1238.
[29]
Brunet MC, Chen SH, Peterson EC. Transradial access for neurointerventions: management of access challenges and complications[J]. J Neurointerv Surg, 2020, 12(1): 82-86.
[30]
Zhang T, Zhao J, Li X, et al. Chinese stroke association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of stroke rehabilitation[J]. Stroke Vasc Neurol, 2020, 5(3): 250-259.
[31]
Beltrán Romero LM, Vallejo-Vaz AJ, Muñiz Grijalvo O. Cerebrovascular disease and statins[J]. Front Cardiovasc Med, 2021, 8: 778740.
[32]
Goyal M, Menon BK, Van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials[J]. Lancet, 2016, 387(10029): 1723-1731.
[33]
Jadhav AP, Desai SM, Jovin TG. Indications for mechanical thrombectomy for acute ischemic stroke: current guidelines and beyond[J]. Neurology, 2021, 97(20 Suppl 2): S126-S136.
[34]
Haussen DC, Nogueira RG, Desousa KG, et al. Transradial access in acute ischemic stroke intervention[J]. J Neurointerv Surg, 2016, 8(3): 247-250.
[35]
Siddiqui AH, Waqas M, Neumaier J, et al. Radial first or patient first: a case series and meta-analysis of transradial versus transfemoral access for acute ischemic stroke intervention[J]. J Neurointerv Surg, 2021, 13(8): 687-692.
[36]
Chen SH, Snelling BM, Sur S, et al. Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: comparison of technical and clinical outcomes[J]. J Neurointerv Surg, 2019, 11(9): 874-878.
[37]
Ramzan A, Kobeissi H, Ghozy S, et al. Transradial balloon guide catheter placement for acute ischemic stroke thrombectomy: a systematic review and meta-analysis[J]. Interv Neuroradiol, 2023: 15910199231171955.
[38]
Gao F, Lo W J, Sun X, et al. Selective use of transradial access for endovascular treatment of severe intracranial vertebrobasilar artery stenosis[J]. Clin Neurol Neurosurg, 2015, 134: 116-121.
[39]
Folmar J, Sachar R, Mann T. Transradial approach for carotid artery stenting: a feasibility study[J]. Catheter Cardiovasc Interv, 2007, 69(3): 355-361.
[40]
Etxegoien N, Rhyne D, Kedev S, et al. The transradial approach for carotid artery stenting[J]. Catheter Cardiovasc Interv, 2012, 80(7): 1081-1087.
[41]
Chandra A, Stone CR, Du X, et al. The cerebral circulation and cerebrovascular disease Ⅲ: stroke[J]. Brain Circ, 2017, 3(2): 66-77.
[42]
Broderick JP, Grotta JC, Naidech AM, et al. The story of intracerebral hemorrhage: from recalcitrant to treatable disease[J]. Stroke, 2021, 52(5): 1905-1914.
[43]
López-Callejas O, Ortiz-Giraldo AF, Vera DD, et al. Flow diverter treatment for non-ruptured carotid aneurysms: efficacy and safety[J]. Neurointervention, 2023, 18(1): 23-29.
[44]
Goland J, Doroszuk G. Transradial approach for endovascular diagnosis and treatment of ruptured cerebral aneurysms: a descriptive study[J]. Surg Neurol Int, 2019, 10: 87.
[45]
Huang X, Xiong Y, Guo X, et al. Transradial versus transfemoral access for endovascular therapy of intracranial aneurysms: a systematic review and meta-analysis of cohort studies[J]. Neurosurg Rev, 2022, 45(6): 3489-3498.
[46]
Luther E, Mccarthy D, Silva M, et al. Bilateral transradial access for complex posterior circulation interventions[J]. World Neurosurg, 2020, 139: 101-105.
[47]
Sweid A, Starke RM, Herial N, et al. Transradial approach for the treatment of brain aneurysms using flow diversion: feasibility, safety, and outcomes[J]. J Neurosurg Sci, 2019, 63(5): 509-517.
[48]
Lawton MT, Rutledge WC, Kim H, et al. Brain arteriovenous malformations[J]. Nat Rev Dis Primers, 2015, 1: 15008.
[1] 赖凌峰, 黄小飞, 丁聪, 周小兵. 血流导向装置治疗血泡样动脉瘤的临床效果分析[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 166-170.
[2] 王增龙, 顾梅, 杭宇, 刘圣, 施海彬, 包建英. 急性大血管闭塞性脑卒中患者血管内治疗后吞咽障碍发生的危险因素分析[J]. 中华介入放射学电子杂志, 2024, 12(01): 10-14.
[3] 许少睿, 孔杰, 马骏, 尚金林, 苏浩波. 西门子Artis Zee系列神经介入术专属透视策略的创建与应用[J]. 中华介入放射学电子杂志, 2023, 11(04): 318-323.
[4] 徐志嘉, 贾振宇, 赵林波, 刘圣, 施海彬, 曹月洲. 高敏肌钙蛋白T动态变化在晚时间窗内进行血管内治疗的急性缺血性脑卒中患者中的预测价值[J]. 中华介入放射学电子杂志, 2023, 11(01): 42-47.
[5] 赖和泰, 刘羽, 程光森, 刘永康, 李忠亮, 陆骊工. 39例Surpass Streamline治疗未破裂动脉瘤患者诊疗分析:单中心临床经验[J]. 中华介入放射学电子杂志, 2023, 11(01): 19-24.
[6] 程娅雯, 韩香凝, 朱宁, 何彩莲, 张润宁, 于嘉, 韩建峰, 刘福德. 双路途指导下血管内治疗症状性非急性颈内动脉颅内段闭塞的疗效观察[J]. 中华脑血管病杂志(电子版), 2024, 18(04): 330-337.
[7] 陈鲲鹏, 陆军, 祁鹏, 王俊杰, 胡深, 杨希孟, 邓颖, 裴傲, 王大明. 应用脑膜中动脉栓塞术治疗慢性硬脑膜下血肿的临床观察[J]. 中华脑血管病杂志(电子版), 2024, 18(03): 236-242.
[8] 许英, 彭采凤, 曾梁楠, 李倩茜, 杨昌美. 未破裂颅内动脉瘤介入治疗患者自我管理干预方案的构建[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 164-170.
[9] 杨海华, 袁景林, 周晓梅, 陈娜, 牛军伟. 以局部麻醉为首要麻醉模式在急性前循环缺血性脑血管病机械取栓术中的有效性及安全性[J]. 中华脑血管病杂志(电子版), 2023, 17(06): 565-570.
[10] 王俊杰, 尹晓亮, 刘二腾, 陆军, 祁鹏, 胡深, 杨希孟, 陈鲲鹏, 张东, 王大明. 机器学习对预测颈内动脉非急性闭塞患者血管内再通术成功的潜在价值[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 464-470.
[11] 孙洪扬, 刘基, 龚字翔, 王广英, 宁召腾, 赵璇, 朱其义, 王贤军. 急性前循环大血管闭塞性轻型卒中血管内治疗的临床预后及手术时机选择[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 445-451.
[12] 袁兴运, 陈万红, 鱼丽萍, 姚力. 以Wallenberg综合征起病的椎动脉颅外段闭塞介入治疗探讨[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 394-399.
[13] 杜小林, 陈鄂, 康俊龙, 肖庆, 丰伟, 田新华. 椎-基底动脉夹层动脉瘤介入治疗的疗效分析[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 350-358.
[14] 黎丹丹, 程峙娟, 刘旭, 陈未平, 殷敏, 郭华, 涂江龙. 急性后循环进展性缺血性卒中患者血管内治疗的效果[J]. 中华脑血管病杂志(电子版), 2023, 17(02): 112-123.
[15] 张文胜, 幸伟芳, 谢颖, 何锦照. 急性前循环大血管闭塞血管内治疗头颅CT高密度影的研究进展[J]. 中华脑血管病杂志(电子版), 2023, 17(02): 159-162.
阅读次数
全文


摘要