• Journal of Korean Neurosurgical Society
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• 제53권4호
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• pp.213-217
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• 2013

Objective : Transradial angiography has become popular among many cardiologists as a diagnostic and therapeutic tool. However, transradial cerebral angiography is not utilized to the same extent. The purpose of this study is to present our experience regarding the usefulness of transradial cerebral angiography, especially in elderly patients. Methods : Between May 2011 and February 2012, a total of 126 cerebral angiographies were performed via a transradial approach in a single center. Of them, only 47 patients were over 60 years old. In our institution, we shifted the initial access from the right femoral artery to the right radial artery in all patients requiring cerebral angiography in 2011. We did not attempt radial access in 40 cases for variable reasons. Results : The procedural success rate was 92.2%. We have four failures of transradial angiography; two because of loop formations of the radial and brachial artery and two due to multiple puncture failures. All supra-aortic vessels were successfully catheterized. However, the selective catheterization rates of the left side distal vessels were lower, as success rates were 89.7% for the right internal carotid artery and 75% for the left internal carotid artery. Procedure-related vascular complications, such as puncture site hematoma, hand ischemia, pseudoaneurysm, arteriovenous fistula and arterial dissection were not observed in our series. However, intraprocedural thrombosis developed in one patient, which was resolved completely by intraarterial thrombolytic agents. Conclusion : With advancing patient's age, we believe that transradial cerebral angiography is a useful tool to decrease patient's discomfort and more effectively manage the vessel tortuosity.

• Journal of Korean Neurosurgical Society
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• 제47권5호
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• pp.332-337
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• 2010

Objective : Although a transradial angiography is accepted as the gold standard for cardiovascular procedures, cerebral angiography has been performed via transfemoral approach in most institutions. The purpose of this study is to present our experience concerning the feasibility, efficacy, and safety of a transradial approach to cerebral angiography as an alternative to a transfemoral approach. Methods : Between February 2007 and October 2009, a total of 1,240 cerebral angiographies were performed via a transradial approach in a single center. The right radial approach was used as an initial access route. The procedure continued only after the ulnar artery was proven to provide satisfactory collateral perfusion according to two tests (a modified Allen's test and forearm angiography). Results : The procedural success rate was 94.8% with a mean duration of 28 minutes. All supra-aortic vessels were successfully catheterized with a success rate of 100%. The success rates of selective catheterization to the right vertebral artery, right internal carotid artery, left internal carotid artery, and left vertebral artery were 96.1%, 98.6%, 82.6% and 52.2%, respectively. The procedure was performed more than twice in 73 patients (5.9%), including up to 4 times in 2 patients. The radial artery occlusion was found in 4 patients (5.4%) on follow-up cerebral angiography, but no ischemic symptoms were observed in any of the cases. Conclusion : This study suggests that cerebral angiography using a transradial approach can be performed with minimal risk of morbidity. In particular, this procedure might be useful for follow-up angiographies and place less stress on patients.

• Journal of Chest Surgery
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• 제45권6호
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• pp.421-423
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• 2012

Transradial access is a widely accepted method for percutaneous coronary diagnostic and interventional procedures, and it has dramatically reduced access site vascular complications compared to transfemoral access. Arteriovenous fistula formation at the access site is an especially rare complication in transradial access. We report an extremely rare case of delayed radial arteriovenous fistula that developed one year after transradial coronary angiography, which was successfully treated by surgical repair.

• 대한간호학회지
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• 제48권4호
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• pp.465-474
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• 2018

Purpose: This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention. Methods: This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test. Results: Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p<.001), pulse (F=12.92, p<.001), and respiration rate (${\times}^2=19.35$, p<.001). Conclusion: Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.

• Journal of Yeungnam Medical Science
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• 제29권1호
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• pp.61-64
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• 2012

The left aortic arch with an aberrant right subclavian artery, or arteria lusoria, is the most common aortic arch anomaly, occurring in 0.5-2.5% of individuals. In such cases, the angular course of the arteria lusoria to the ascending aorta imposes difficulty in passing a guide wire to the ascending aorta during right transradial catheterization. Here, the case of a 53-year-old woman with intermittent chest tightness and coughing is reported. Aberrant right subclavian artery (arteria lusoria) was diagnosed via aortogram during right transradial coronary angiography. Compression of the esophagus and trachea by the aberrant right subclavian artery was demonstrated by chest computed tomography (CT).

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.94-98
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• 2018

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

• Korean Journal of Radiology
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• 제22권1호
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• pp.72-85
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• 2021

Transfemoral access (TFA) is a widely used first-line approach for most peripheral vascular interventions. Since its introduction in cardiologic and neurointerventional procedures, several advantages of transradial access (TRA) over TFA have been demonstrated, such as patient preference, lower complication rates, early ambulation, and shorter hospital stay. However, studies reporting the safety and efficacy of this approach for peripheral vascular interventions performed by interventional radiologists are relatively few. This review aimed to summarize the technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization and the management of complications.

• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.499-503
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• 2015

Objective : The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods : Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results : The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was $13.41{\pm}2.19mm$, and the RSP was $26.85{\pm}2.47mm$ from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as $44.23{\pm}5.47mm$, whereas the distance between the ME and the MN was $42.23{\pm}4.77mm$. The average VAO-ScA angle was $70.94{\pm}6.12^{\circ}$, and the length between the ScA junction (SCJ) and the VAO was $60.30{\pm}8.48mm$. Conclusion : This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.

• 대한방사선협회지
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• 제27권2호
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• pp.175-180
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• 2001

Ⅰ. Background and Objectives : Recently the percutaneous transradial approach for coronary angiography and angioplasty has been using. When the radial artery as a graft for coronary artery bypass surgery was used, pantency increased. Many examination and

• Journal of Chest Surgery
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• 제37권11호
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• pp.897-902
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• 2004

배경: 관상동맥조영술 또는 중재술에 사용된 요골동맥을 관상동맥우회술시 우회도관으로 사용하는 경우가 늘고 있으나 이로 인한 요골동맥도관의 개존성 및 환자의 임상성적에 미치는 영향에 대해 체계적인 연구는 보고되고 있지 않다. 이에 본 저자들은 관상동맥조영술에 사용된 요골동맥을 우회도 관으로 사용한 환자들의 임상성적과 술 후 개존도를 그렇지 않은 환자들과 비교 분석하고자 하였다. 대상 및 방법: 2000년 1월 부터 2004년 2월까지 관상동맥조영술에 사용된 요골동맥을 동맥도관으로 사용한 49예를 I군으로, 관상동맥조영술에 산이지 않은 요골동맥을 동맥도관으로 사용한 44예를 II군으로 정하여 두 군간에 성비, 나이, 술 전 위험인자, 과거력, 임상진단, 수술방법, 수술성적, 우회도관의 개존도 등을 후향적으로 비교 분석하였다. 결과: 두 군 간 남녀비, 연령, 진단명, 수술 위험인자, 심박출률 등의 유의한 차이는 없었다. 술 전 관상동맥조영술은 I군에서는 전예에서 좌측 요골동맥을 이용하였고 II군에서는 대퇴동맥 혹은 우측 요골동맥을 이용하였다. 수술은 전예에서 인공심폐기를 이용한 관상동맥우회술을 시행하였으며 수술사망은 양군에서 모두 없었고 주요합병증은 I군은 5예(10%), II군은 3예(7%) 있었다. 수술에 이용된 우회도관으로는 양군에서 내흉동맥, 요골동맥, 대복재 정맥을 주로 이용하였고 I군은 환자당 평균 3.7$\pm$1.1원위부문합, II군은 3.7$\pm$0.9원위부문합을 시행하였고 요골동맥절편은 I군에서 환자당 평균 1.2$\pm$0.4원위부문합, II군에서 1.3$\pm$0.5원위부문합을 시행하였다. 요골동맥의 원위부문합은 양 군에서 회선지 부위가 가장 많았고 근위부문합은 두군에서 모두 상행대동맥, 내흉동맥, 대복재정맥 후드 순이었다. 수술 후 관상동맥조영술상 양군에서 내흉동맥과 요골동맥은 모두 100%의 개존도를 보였으며 대복재정맥은 I군 85%, II군 86%의 개존도를 보였다. 요골동맥절편에서 완전개존이 I군에서 93%로 II군의 81%보다 오히려 높게 나왔으나 유의하지는 않았다. 결론: 술 후 시행한 관상동맥조영술에서 양군에 개존율에 큰 차이는 없었으며 수술 전 관상동맥 조영술에 사용된 요골동맥도 비교적 안전하게 관상동맥우회술의 우회도관으로 사용할 수 있다고 판단된다.