高级检索
刘浩, 董智慧, 符伟国. 经桡动脉入路介入治疗并发症的血管外科处理[J]. 中国临床医学, 2024, 31(1): 25-29. DOI: 10.12025/j.issn.1008-6358.2024.20240148
引用本文: 刘浩, 董智慧, 符伟国. 经桡动脉入路介入治疗并发症的血管外科处理[J]. 中国临床医学, 2024, 31(1): 25-29. DOI: 10.12025/j.issn.1008-6358.2024.20240148
LIU Hao, DONG Zhihui, FU Weiguo. Management of vascular surgery in treatment of transradial access-related interventional therapy complications[J]. Chinese Journal of Clinical Medicine, 2024, 31(1): 25-29. DOI: 10.12025/j.issn.1008-6358.2024.20240148
Citation: LIU Hao, DONG Zhihui, FU Weiguo. Management of vascular surgery in treatment of transradial access-related interventional therapy complications[J]. Chinese Journal of Clinical Medicine, 2024, 31(1): 25-29. DOI: 10.12025/j.issn.1008-6358.2024.20240148

经桡动脉入路介入治疗并发症的血管外科处理

Management of vascular surgery in treatment of transradial access-related interventional therapy complications

  • 摘要: 经桡动脉入路(transradial access, TRA)现已成为冠状动脉(冠脉)介入治疗的首选入路方式。随着TRA患者数量的增加, 其并发症也引起了临床医生的关注。TRA相关并发症可根据发生时期分为术中、术后并发症, 根据是否涉及出血事件分为出血性、非出血性并发症。若能早期识别术中并发症如桡动脉夹层、穿孔、痉挛及导管弯折断裂等, 可通过腔内方法干预, 预后良好。术中并发症及穿刺点处理不当可发生血肿、假性动脉瘤及动静脉瘘, 对于上述并发症, 若保守治疗方法无效, 应尽早外科干预, 避免出现前臂骨筋膜室综合征导致截肢。桡动脉闭塞为最常见的TRA相关并发症, 患者可能无手部缺血症状, 但通畅的桡动脉有重要临床意义。因此, 对于桡动脉闭塞, 应及时监测、尽早发现并干预。目前, TRA相关并发症的研究较少, 且病例数量有限, 亟需大样本高质量临床研究。

     

    Abstract:
    Objective Transradial access (TRA) has become the primary access for coronary intervention. With the increase in the number of patients with TRA, its complications have attracted the attention of clinicians.TRA-related complications can be categorized into intraoperative and postoperative complications according to the period of occurrence, and into hemorrhagic and nonhemorrhagic complications according to whether bleeding events are involved or not. If intraoperative complications such as radial artery entrapment, perforation, spasm, and catheter bending and fracture can be recognized early, they can be intervened by endoluminal methods and have a good prognosis. Hematoma, pseudoaneurysm and arteriovenous fistulae can occur as a result of intraoperative complications and improper management of the puncture point, for which early surgical intervention should be made if conservative methods fail to work in order to avoid forearm osteofascial compartment syndrome leading to amputation. Radial artery occlusion, as the most common TRA-related complication, patients may not have hand ischemia symptoms, but radial artery patency is clinically important, so radial artery occlusion should be monitored, detected and intervened as early as possible. Currently, there are few studies on TRA-related complications and a limited number of cases, and large-sample, high-quality clinical studies are urgently needed.

     

/

返回文章
返回