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刘 斌,李 智,杨志刚. 经桡动脉入路在神经介入手术中应用的思考[J]. 中国临床医学, 2024, 31(1): 12-16. DOI: 10.12025/j.issn.1008-6358.2024.20240195
引用本文: 刘 斌,李 智,杨志刚. 经桡动脉入路在神经介入手术中应用的思考[J]. 中国临床医学, 2024, 31(1): 12-16. DOI: 10.12025/j.issn.1008-6358.2024.20240195
LIU Bin, LI Zhi, YANG Zhigang. Critical thinking of transradial access in neurointerventional surgery[J]. Chin J Clin Med, 2024, 31(1): 12-16. DOI: 10.12025/j.issn.1008-6358.2024.20240195
Citation: LIU Bin, LI Zhi, YANG Zhigang. Critical thinking of transradial access in neurointerventional surgery[J]. Chin J Clin Med, 2024, 31(1): 12-16. DOI: 10.12025/j.issn.1008-6358.2024.20240195

经桡动脉入路在神经介入手术中应用的思考

Critical thinking of transradial access in neurointerventional surgery

  • 摘要: 经桡动脉入路在神经介入治疗领域越来越受到重视, 其具有并发症少, 满意度高等优点, 但存在学习曲线长、受到桡动脉及上肩部解剖因素限制、专用器械缺乏等缺点及难点。经桡动脉入路很少存在绝对禁忌证, 远端及左侧桡动脉入路也逐渐作为入路选择, 而通过无鞘经桡动脉入路或更大内腔的桡动脉鞘及器材组合, 可以更广泛地开展各种神经介入手术。但在目前缺乏高级别证据的背景下, 经桡动脉入路在颅内动脉瘤、颈动脉支架、机械取栓等神经介入治疗场景中仍存在一定困难及挑战, 应用时更应权衡利弊。

     

    Abstract: Transradial access has been more and more used in the neurointerventional surgery nerve interventional therapy, with the advantages of fewer complications and higher satisfaction. However, it has the disadvantages and difficulties of long learning curve, be limited by anatomical factors of radial artery and upper shoulder vessels, and lack of special instruments for nerve intervention. There are few absolute contraindications to the transradial approach, and the distal and the left radial approachs are increasingly used as the choices of approach. The transradial access without sheath or with larger-lumen sheath and the combination of materials are helpful to carry out various nerve intervention operations. However, in the absence of high-level evidence, there are difficulties and challenges in the interventional treatments of intracranial aneurysms, carotid artery stenting and mechanical thrombectomy. A scientific and cautious attitude is needed in neurointerventional surgery by the transradial access.

     

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