Effectiveness, Safety and Satisfaction of Distal Transradial Artery Approach in Cerebral Angiography

doi:10.12114/j.issn.1007-9572.2022.0882

Chinese General Practice ›› 2023, Vol. 26 ›› Issue (27): 3378-3382.DOI: 10.12114/j.issn.1007-9572.2022.0882

Special Issue: 脑健康最新研究合辑

• Monographic Research • Previous Articles Next Articles

Effectiveness, Safety and Satisfaction of Distal Transradial Artery Approach in Cerebral Angiography

1. Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University/The Wujin Clinical College of Xuzhou Medical University, Changzhou 213000, China
2. Cardiovascular Department, Wujin Hospital Affiliated with Jiangsu University/The Wujin Clinical College of Xuzhou Medical University, Changzhou 213000, China
3. Medical Laboratory, Wujin Hospital Affiliated with Jiangsu University/The Wujin Clinical College of Xuzhou Medical University, Changzhou 213000, China

Received:2022-10-10 Revised:2023-03-23 Published:2023-09-20 Online:2023-04-14
Contact: YUAN Xuesong

经远端桡动脉入径在脑血管造影中的有效性、安全性及满意度研究

1．213000　江苏省常州市，江苏大学附属武进医院　徐州医科大学武进临床学院神经外科
2．213000　江苏省常州市，江苏大学附属武进医院　徐州医科大学武进临床学院心血管内科
3．213000　江苏省常州市，江苏大学附属武进医院　徐州医科大学武进临床学院医学检验科

通讯作者: 袁雪松
作者简介:
作者贡献：陆彬进行文章的构思与设计、可行性分析，负责文献/资料收集、整理及论文撰写；陆彬、项崇、严永敏进行论文及英文的修订；袁雪松、蔡高军、魏文锋负责文章的质量控制及审校；袁雪松对文章整体负责，监督管理。
基金资助:
江苏省重点研发计划（社会发展）项目(BE2021690); 常州市社会发展科技项目(CE20225003); 常州市武进区第三批科技计划项目(WS202024)

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Abstract

Abstract:

Background

Cerebral angiography is an important means for the assessment of cerebrovascular diseases. In recent years, distal transradial artery approach (dTRA) has gradually been used in cerebral angiography, but there are few reports on its effectiveness and safety.

Objective

To compare the effectiveness, patient safety and satisfaction between transradial artery approach (TRA) and dTRA in cerebral angiography.

Methods

Totally 135 patients who were hospitalized in Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University from January 2020 to June 2022 for cerebral angiography were selected. They were divided into TRA group (n=72) and dTRA group (n=63) by the approach used in cerebral angiography, and the puncture time, duration of cerebral angiography, puncture success rate, X-ray exposure time, incidence of puncture site complications and serious cardiovascular and cerebrovascular events within three days after cerebral angiography, and levels of pain and satisfaction within 24 hours after cerebral angiography were compared between the groups.

Results

The mean puncture time in dTRA group was much longer than that of TRA group (P<0.05) . The mean duration of cerebral angiography was also significantly longer in dTRA group (P<0.05) . The puncture success rate in dTRA group was much lower (P<0.05) . There was no statistically significant difference between the groups in terms of average X-ray exposure time or the incidence of puncture site complications within three days after cerebral angiography (P>0.05) . No serious cardiovascular and cerebrovascular events occurred in both groups within three days after cerebral angiography. dTRA group had much lighter pain level and significantly higher satisfaction within 24 hours after cerebral angiography than TRA group (P<0.05) .

Conclusion

Compared with TRA, dTRA is also safe and effective for cerebral angiography, and helps to reduce patients' pain level and improve their satisfaction, so dTRA can be used as one alternative approach for cerebral angiography, but it requires higher level of puncture skills and takes a longer time, so operators need to spend a certain amount of time on relevant learning and training.

Key words: Cerebrovascular diseases, Cerebral angiography, Radial artery, Distal radial artery, Treatment outcome, Safety

摘要：

背景

脑血管造影在脑血管疾病的诊断中具有重要作用，近年来经远端桡动脉入径（dTRA）逐渐应用于脑血管造影，但目前关于其有效性、安全性的研究报道较少见。

目的

对比经桡动脉入径（TRA）与dTRA行脑血管造影的有效性、安全性及满意度。

方法

选取2020年1月—2022年6月在江苏大学附属武进医院神经外科住院并行脑血管造影的患者135例。根据脑血管造影入径分为TRA组（n=72）与dTRA组（n=63），分别采用TRA、dTRA完成脑血管造影。比较两组患者穿刺时间、脑血管造影时间、穿刺成功率、X线暴露时间、脑血管造影后3 d内穿刺点并发症及严重心脑血管事件发生情况、脑血管造影后24 h疼痛程度和满意度。

结果

dTRA组患者穿刺时间、脑血管造影时间长于TRA组，穿刺成功率低于TRA组（P<0.05）。两组患者X线暴露时间、脑血管造影后3 d内穿刺点并发症发生率比较，差异无统计学意义（P>0.05）。两组患者脑血管造影后3 d内均未出现严重心脑血管事件。dTRA组患者脑血管造影后24 h疼痛程度轻于TRA组，满意度高于TRA组（P<0.05）。

结论

与TRA行脑血管造影相比，dTRA行脑血管造影亦安全、有效，有利于减轻患者疼痛，提高患者满意度，可作为脑血管造影的备选入径之一，但其穿刺难度较高，穿刺时间较长，存在一定的"学习曲线"。

关键词: 脑血管疾病, 脑血管造影术, 桡动脉, 远端桡动脉, 治疗结果, 安全

LU Bin,XIANG Chong,YUAN Xuesong, et al. Effectiveness, Safety and Satisfaction of Distal Transradial Artery Approach in Cerebral Angiography[J]. Chinese General Practice, 2023, 26(27): 3378-3382. DOI: 10.12114/j.issn.1007-9572.2022.0882.
陆彬,项崇,袁雪松等. 经远端桡动脉入径在脑血管造影中的有效性、安全性及满意度研究[J]. 中国全科医学, 2023, 26(27): 3378-3382. DOI: 10.12114/j.issn.1007-9572.2022.0882.

Figures/Tables 4

References 20

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组别	例数	性别（男/女）	年龄（±s，岁）	基础疾病〔例（%）〕
组别	例数	性别（男/女）	年龄（±s，岁）	高血压	糖尿病	高脂血症
TRA组	72	27/45	55.6±9.0	50（69.4）	22（30.6）	16（22.2）
dTRA组	63	30/33	55.3±10.0	42（66.7）	20（31.7）	16（25.4）
χ²（t）值		1.410	0.204^a	0.120	0.022	0.187
P值		0.235	0.839	0.730	0.882	0.665

组别	例数	性别（男/女）	年龄（±s，岁）	基础疾病〔例（%）〕
组别	例数	性别（男/女）	年龄（±s，岁）	高血压	糖尿病	高脂血症
TRA组	72	27/45	55.6±9.0	50（69.4）	22（30.6）	16（22.2）
dTRA组	63	30/33	55.3±10.0	42（66.7）	20（31.7）	16（25.4）
χ²（t）值		1.410	0.204^a	0.120	0.022	0.187
P值		0.235	0.839	0.730	0.882	0.665

组别	例数	穿刺时间（min）	脑血管造影时间（min）	穿刺成功率〔例（%）〕
TRA组	72	3.9±0.6	34.3±5.9	72（100.0）
dTRA组	63	5.6±2.2	37.9±10.5	59（93.7）
t（χ²）值		5.890	2.380	4.711^a
P值		<0.001	0.019	0.030

组别	例数	穿刺时间（min）	脑血管造影时间（min）	穿刺成功率〔例（%）〕
TRA组	72	3.9±0.6	34.3±5.9	72（100.0）
dTRA组	63	5.6±2.2	37.9±10.5	59（93.7）
t（χ²）值		5.890	2.380	4.711^a
P值		<0.001	0.019	0.030

组别	例数	疼痛程度				满意度
组别	例数	无痛	轻度疼痛	中度疼痛	重度疼痛	十分满意	一般满意	不满意
TRA组	72	28（38.9）	28（38.9）	13（18.1）	3（4.1）	25（34.7）	30（41.7）	17（23.6）
dTRA组	63	41（65.1）	20（31.7）	2（3.2）	0	36（57.2）	22（34.9）	5（7.9）
Z值		-3.550				-2.975
P值		<0.001				<0.010

Effectiveness, Safety and Satisfaction of Distal Transradial Artery Approach in Cerebral Angiography

经远端桡动脉入径在脑血管造影中的有效性、安全性及满意度研究

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