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Predictors of difficult vascular access during transradial neurointervention: a retrospective study.

Predictors of difficult vascular access during transradial neurointervention: a retrospective study.

期刊: Revista da Associacao Medica Brasileira (1992) 日期: 2026-01-01 PMID: 42339907 DOI: 10.1590/1806-9282.20260021 浏览: 23
作者: Wu J, Zhang F, Li Q, Qi B
J, W., F, Z., Q, L., & B, Q. (2026). Predictors of difficult vascular access during transradial neurointervention: a retrospective study.. Revista da Associacao Medica Brasileira (1992). https://doi.org/10.1590/1806-9282.20260021
J W, F Z, Q L, B Q. Predictors of difficult vascular access during transradial neurointervention: a retrospective study.. Revista da Associacao Medica Brasileira (1992). 2026; doi: 10.1590/1806-9282.20260021
J W, F Z, Q L, et al. Predictors of difficult vascular access during transradial neurointervention: a retrospective study.[J]. Revista da Associacao Medica Brasileira (1992). 2026. DOI: 10.1590/1806-9282.20260021.
@article{j2026,
  author = {Wu J and Zhang F and Li Q and Qi B},
  title = {Predictors of difficult vascular access during transradial neurointervention: a retrospective study.},
  journal = {Revista da Associacao Medica Brasileira (1992)},
  year = {2026},
  doi = {10.1590/1806-9282.20260021},
  note = {PMID: 42339907},
}
TY  - JOUR
AU  - Wu J
AU  - Zhang F
AU  - Li Q
AU  - Qi B
TI  - Predictors of difficult vascular access during transradial neurointervention: a retrospective study.
T2  - Revista da Associacao Medica Brasileira (1992)
PY  - 2026
DO  - 10.1590/1806-9282.20260021
AN  - PMID:42339907
ER  - 

摘要

OBJECTIVE: The aim of this study was to identify factors associated with difficulty in establishing vascular access during the transradial approach for neurointerventional therapy. METHODS: We retrospectively analyzed consecutive patients who successfully underwent transradial approach neurointerventional therapy at Fudan Zhongshan Xiamen Hospital (July 2021-July 2024). Patients were categorized as "difficult" or "easy" according to whether vascular access establishment required >15 min. Collected variables included difficulty in radial artery puncture/sheath insertion, feasibility of routinely forming a Simmons-2 catheter, aortic arch type (II-III), tortuosity of the brachiocephalic trunk, brachiocephalic trunk-target common carotid artery angle (<30°), and tortuosity of the C2-C4 internal carotid artery. Multivariate logistic regression was performed to identify independent factors. RESULTS: Among 277 patients, 199 were in the easy group and 78 were in the difficult group. Compared with the easy group, the difficult group more frequently had difficult radial puncture/sheath insertion, brachiocephalic trunk tortuosity, a sharp brachiocephalic trunk-target common carotid artery angle (<30°), C2-C4 internal carotid artery tortuosity, and failure to routinely form a Simmons-2 catheter (all p<0.05). Hypertension, diabetes, hyperlipidemia, and type III aortic arch were not significantly different between groups (all p>0.05). On multivariate analysis, difficult radial puncture/sheath insertion, inability to routinely form a Simmons-2 catheter, brachiocephalic trunk tortuosity, a brachiocephalic trunk-target common carotid artery angle <30°, and C2-C4 internal carotid artery tortuosity were independent factors associated with access difficulty (all p<0.001). CONCLUSION: Both access-site difficulty and unfavorable supra-aortic/internal carotid artery anatomy were independently associated with prolonged vascular access establishment during transradial approach neurointerventional therapy.

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