经桡动脉入路（TRA）治疗桡动脉袢患者的安全性：4年来TRA专用神经血管中心经验的回顾性分析

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-06-27 DOI:10.1016/j.jocn.2025.111400

Wei Cao , Rongguo Hu , Si Zhao Tang , Dandan Jia , Deyuan Zhu , Dayong Qi , Kangqing Zhang , Tonghui Song , Yibin Fang

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引用次数: 0

摘要

桡动脉环的存在-沿桡动脉完整的360°环，使经桡动脉入路（TRA）在神经介入手术中复杂化。我们的研究旨在评估桡动脉袢患者TRA的安全性，并提出桡动脉袢管理策略以提高TRA的成功率。方法本研究是一项单中心回顾性研究，纳入了所有在4年内（2021-2024年）通过TRA行神经介入手术的桡动脉袢患者。收集基线患者特征、相关TRA解剖数据、术中并发症（如血管壁损伤如穿孔）、转股通路、桡动脉通畅3个月的随访数据。结果TRA数据库中29例患者（共945例）存在桡动脉环。患者平均年龄75.5岁，其中男性13例，女性16例。29例患者中27例成功（93.1%）。2例（6.9%）患者发生桡动脉穿孔，均采用手动压迫保守治疗。随访3个月，所有病例均保持桡动脉通畅。结论采用合适的技术治疗桡动脉袢是可行的，且具有良好的安全性。然而，观察到的7%的桡动脉穿孔率强调了谨慎选择病例的必要性，并强调环路导航应保留给具有足够专业知识和临床依据的中心。加强初步超声筛查的作用，特别是在近端扩展时，可能有助于提前识别解剖变异，如径向环，从而减少程序复杂性并改善规划。

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Safety profile of trans-radial approach (TRA) in patients with radial artery loop in neurointervention: retrospective analysis of a TRA-dedicated neurovascular center experience over 4 years

Introduction

The presence of radial artery loops − complete 360° loop along the radial artery, can complicate transradial approach (TRA) in neurointerventional surgeries. Our study aims to evaluate the safety profile of TRA in patients with radial artery loops and proposes strategies for managing radial artery loops to improve the success rate of TRA.

Methods

This is a single-center retrospective study, which included all patients with radial artery loops who underwent neurointerventional procedures via TRA over 4 years (2021–2024). Data on baseline patient characteristics, relevant TRA anatomical data, periprocedural complications (e.g. vessel wall injury e.g. perforation), conversion to femoral access, radial artery patency at 3 months follow-up were collected.

Results

Radial artery loops were present in 29 patients from TRA database (total of 945 patients). The average age of patients was 75.5 years old (13 males, 16 females). TRA was successful in 27 out of 29 patients (93.1 %). Radial artery perforation occurred in 2 patients (6.9 %), both managed conservatively with manual compression. At the 3-month follow-up, radial artery patency was preserved in all cases.

Conclusions

TRA in patients with radial artery loops is feasible with a favorable safety profile when appropriate techniques are employed. However, the observed 7% rate of radial artery perforation highlights the need for careful case selection and emphasizes that loop navigation should be reserved for centers with sufficient expertise and clinical justification. Reinforcing the role of preliminary ultrasound screening, particularly when extended proximally, may help identify anatomical variants such as radial loops in advance, thereby reducing procedural complexity and improving planning.

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.