经尺动脉入路行全脑血管造影及颈动脉支架置入术1例并文献复习

doi:10.3969/j.issn.1673-5765.2023.10.012

中国卒中杂志 ›› 2023, Vol. 18 ›› Issue (10): 1186-1190.DOI: 10.3969/j.issn.1673-5765.2023.10.012

经尺动脉入路行全脑血管造影及颈动脉支架置入术1例并文献复习

吴剑¹，李秋平²，齐飚¹

1 厦门 361000复旦大学附属中山医院厦门医院神经外科
2 复旦大学附属中山医院神经外科

收稿日期:2022-12-27 出版日期:2023-10-20 发布日期:2023-10-20
通讯作者: 李秋平 li.qiuping@zs-hospital.sh.cn
基金资助:
福建省自然科学基金（2022J011429）

Ulnar Artery Approach for Digital Subtraction Angiography and Carotid Artery Stenting: A Case Report and Literature Review

WU Jian¹, LI Qiuping², QI Biao¹

Received:2022-12-27 Online:2023-10-20 Published:2023-10-20

摘要/Abstract

摘要： 近年来经前臂血管入路如桡动脉入路行神经介入治疗已被广泛应用，但部分患者因先天性桡动脉纤细或既往多次桡动脉穿刺后引起桡动脉狭窄甚至闭塞而无法继续经桡动脉入路完成治疗。本病例中患者因左侧颈内动脉起始部重度狭窄需进行介入治疗，其主动脉弓为牛角弓型，适合经桡动脉入路完成手术，然而该患者因既往多次经桡动脉入路进行手术，导致桡动脉纤细，无法进一步完成经桡动脉入路介入治疗。彩超检查发现患者尺动脉直径粗，能耐受彩超置入血管鞘，因此本研究尝试经尺动脉入路完成脑血管造影及颈动脉支架置入术。该患者手术顺利，无并发症发生，为后续经尺动脉入路行神经介入及治疗的研究提供参考。

关键词: 经尺动脉入路; 颈动脉狭窄; 全脑血管造影术; 颈动脉支架置入术

Abstract: In recent years, the transforearm vascular approach such as radial artery approach has been widely used, but some patients cannot continue the radial artery approach due to congenital slender radial artery, radial artery stenosis or even occlusion after previous repeated radial artery punctures. In this case, the patient required interventional therapy for severe stenosis at the origin of the left internal carotid artery. The patient has a bovine aortic arch, which is suitable for the radial artery approach surgery. However, the patient had undergone several previous operations via the radial artery approach, resulting in a slender radial artery, and further radial artery approach for interventional therapy cannot be completed. The color Doppler ultrasonography found that the diameter of ulnar artery was thick enough for puncture and sheath placement. Therefore, this study tried to perform digital subtraction angiography and carotid artery stenting through ulnar artery approach. The operation was successfully completed without complications, providing a reference for the interventional surgery via ulnar artery approach.

Key words: Ulnar artery approach; Carotid artery stenosis; Digital subtraction angiography; Carotid artery stenting

吴剑, 李秋平, 齐飚. 经尺动脉入路行全脑血管造影及颈动脉支架置入术1例并文献复习[J]. 中国卒中杂志, 2023, 18(10): 1186-1190.

WU Jian, LI Qiuping, QI Biao. Ulnar Artery Approach for Digital Subtraction Angiography and Carotid Artery Stenting: A Case Report and Literature Review[J]. Chinese Journal of Stroke, 2023, 18(10): 1186-1190.

参考文献

[1] JOSHI K C，BEER-FURLAN A，CROWLEY R W，et al. Transradial approach for neurointerventions：a systematic review of the literature[J]. J Neurointerv Surg，2020，12（9）：886-892.
[2] FOLMAR J，SACHAR R，MANN T. Transradial approach for carotid artery stenting：a feasibility study[J]. Catheter Cardiovasc Interv，2007，69（3）：355-361.
[3] SLAWIN J，KUBLER P，SZCZEPAŃSKI A，et al. Radial artery occlusion after percutaneous coronary interventions–an underestimated issue[J]. Postepy Kardiol Interwencyjnej，2013，9（4）：353-361.
[4] 傅向华，马宁，刘君，等. 选择性经皮尺动脉入径冠状动脉血管成形治疗的可行性研究[J]. 中华心血管病杂志，2003，31（5）：337-340.
FU X H，MA N，LIU J，et al. Feasibility of percutaneous coronary angioplasty via transulnar artery approach in selective patients with coronary heart disease[J]. Chin J Cardiol，2003，31（5）：337-340.
[5] GENG W，FU X H，GU X S，et al. Safety and feasibility of transulnar versus transradial artery approach for coronary catheterization in non-selective patients[J]. Chin Med J（Engl），2014，127（7）：1222-1228.
[6] KEDEV S，ZAFIROVSKA B，DHARMA S，et al. Safety and feasibility of transulnar catheterization when ipsilateral radial access is not available[J/OL]. Catheter Cardiovasc Interv，2014，83（1）：E51-60[2022-12-20]. https://doi.org/10.1002/ccd.25123.
[7] FERNANDEZ R，ZAKY F，EKMEJIAN A，et al. Safety and efficacy of ulnar artery approach for percutaneous cardiac catheterization：systematic review and meta‐analysis[J]. Catheter Cardiovasc Interv，2018，91（7）：1273-1280.
[8] MANZOOR M U，ALMULHIM I A，ALRASHED A A，et al. Common ground，different path：ulnar artery access for interventional neurovascular procedures[J]. Interv Neuroradiol，2022，28（4）：463-468.
[9] ROGHANI-DEHKORDI F，HOSSEINZADEH H，KERMANI-ALGHORAISHI M，et al. The transulnar approach in the patients with ipsilateral radial artery occlusion[J]. ARYA Atheroscler，2020，16（1）：33-38.
[10] DOSSANI R H，WAQAS M，TSO M K，et al. Safety and feasibility of ulnar artery access for neuroangiography and neurointervention：a case series[J]. J Neurointerv Surg，2021，13（2）：109-113.

[1]	张磊, 王小雅, 坚雅婷, 高震, 樊洪, 范松华, 王虎清, 孙宏, 张茹, 展淑琴, 张桂莲. 症状性颈动脉漂浮血栓的血管内治疗探索[J]. 中国卒中杂志, 2023, 18(10): 1136-1142.
[2]	申园, 王晶, 王安心, 赵性泉. 基于中国社区成年人群超敏C反应蛋白及无症状性颈动脉狭窄与认知障碍的关系研究[J]. 中国卒中杂志, 2023, 18(05): 556-563.
[3]	夏丽萍, 郑文玲, 邹云涛, 冯乐燕, 贾玉勤. 颈动脉支架置入术后发生需药物干预低血流动力学状态的危险因素分析 [J]. 中国卒中杂志, 2023, 18(04): 472-477.
[4]	王文洁, 吕书玉, 侯叶叶, 毛佳文, 韩颖, 李子孝. 缺血性脑血管病：回眸2022[J]. 中国卒中杂志, 2023, 18(02): 123-132.
[5]	张亮, 贺雄军, 黎凯锋, 周宏星, 胡明, 刘亚杰. 对比剂过敏患者在无造影下行颈动脉支架置入术1例报道[J]. 中国卒中杂志, 2022, 17(10): 1108-1111.
[6]	聂创，吴祥波，康志明，梅斌. 放疗后颈动脉狭窄血管内介入治疗1例报告并文献复习[J]. 中国卒中杂志, 2020, 15(10): 1103-1106.
[7]	滕乐群，沈晨阳. 颈动脉血管重建术对颈动脉狭窄患者认知功能的影响[J]. 中国卒中杂志, 2020, 15(10): 1128-1133.
[8]	易立，杨伊姝，张婷婷，陈彬，汤劼. 正五聚蛋白3与缺血性卒中患者颈动脉狭窄的关系研究[J]. 中国卒中杂志, 2020, 15(05): 522-526.
[9]	王翩，王琰，李虹庆. 颈动脉支架置入术后支架内血栓形成研究进展[J]. 中国卒中杂志, 2019, 14(06): 625-629.
[10]	钟涛, 刘东涛, 马向科, 王剑锋, 贾伟华. 无症状性颈动脉狭窄患者不同治疗方式后的临床结局[J]. 中国卒中杂志, 2018, 13(08): 790-794.
[11]	陈宇，刘昌伟，刘志丽，吴巍巍，曾嵘，宋小军，刘暴. 颈动脉内膜剥脱术和颈动脉支架的疗效分析[J]. 中国卒中杂志, 2016, 11(07): 536-541.
[12]	王拥军. 新时代的开始[J]. 中国卒中杂志, 2016, 11(03): 165-167.
[13]	蔡艺灵，刘丽. 高度警惕脑高灌注综合征[J]. 中国卒中杂志, 2016, 11(03): 169-173.
[14]	刘丽，崔永强，杜娟，吴铮，林甜，于一娇，韩雪，郑雅静，蔡艺灵. 脑血管支架成形术后脑高灌注综合征[J]. 中国卒中杂志, 2016, 11(03): 174-178.
[15]	林甜，杜娟，刘丽，吴铮，孔祥锴，刘煜，蔡艺灵. 颈动脉支架置入术后脑过度灌注综合征一例报道[J]. 中国卒中杂志, 2016, 11(03): 221-225.

经尺动脉入路行全脑血管造影及颈动脉支架置入术1例并文献复习

Ulnar Artery Approach for Digital Subtraction Angiography and Carotid Artery Stenting: A Case Report and Literature Review

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics