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Why Do More People Choose Radial Artery as the Access Site for Vascular Intervention Procedures?
The Technology of Vascular Interventional Surgery
Vascular interventional technique (vascular interventional technique) is an operative technique that uses instruments such as puncture needles, guidewires, and catheters to diagnose and treat through blood vessels under the guidance of medical imaging equipment.
Conventional vascular interventions mainly includes balloon angioplasty, stent implantation, catheter thrombolysis, plaque rotation, and mechanical thrombectomy. Arterial puncture is the first step in interventional surgery. Currently, the commonly chosen arteries for puncture are the radial artery and femoral artery. Rapid and accurate puncture success is a key guarantee for surgical success.
Radial Artery Puncture and Vascular Interventional Surgery
Treatment of coronary artery through the femoral artery is the most classic and widely used approach. Compared with radial artery puncture, femoral artery puncture technique is relatively simple, and even beginners can quickly master it.
Secondly, the femoral artery has a large inner diameter, which allows for the use of any desired catheter. This ensures that the vascular access is not damaged while rapidly inserting instruments, saving time for the surgical procedure.
However, the disadvantages of femoral artery puncture are also evident. The groin area is rich in blood vessels and nerves, making it prone to accidental injury. For example, the femoral vein is located inside the femoral artery, and the femoral nerve runs outside it. 5% to 10% of patients experience complications after local vascular puncture, including bleeding, hematoma, pseudoaneurysm, arteriovenous fistula, nerve damage, etc.
In particular, there is a risk of retroperitoneal bleeding, which can lead to death in severe cases. In order to reduce bleeding complications, patients often need to stay in bed for a long time after surgery, resulting in a long recovery time and hospitalization period. This is not conducive to saving manpower and enhancing the utilization rate of beds, and also leads to unnecessary increases in medical expenses. The wound in the groin area is also prone to contamination, and the incidence of local complications is higher than that of radial artery puncture.
Compared with femoral artery access, radial artery intervention treatment has many obvious advantages. Firstly, there are no large veins or nerves near the radial artery puncture site, and there is an Allen's loop collateral circulation between the radial and ulnar arteries, which makes the occurrence of arteriovenous fistula, nerve damage, or hand ischemia extremely rare.
Secondly, patients who undergo radial artery puncture intervention treatment can immediately remove the sheath and perform compression, reducing the possibility of deep vein thrombosis and pulmonary embolism caused by long-term bed rest, which is beneficial to the patient's postoperative recovery.
Due to the quick recovery of patients who undergo radial artery puncture, the length of hospital stay can be greatly reduced, and the procedure can even be performed on an outpatient basis, resulting in a significant reduction in medical expenses.
Currently, almost all complex interventional procedures can be completed using a 6F guiding catheter through the radial artery route. Most operators have made radial artery puncture the preferred approach for percutaneous coronary interventionals.
Although radial artery access is widely welcomed by coronary interventional doctors, it still has its own problems. The radial artery has a small diameter and is one of the most easily spasming muscular vessels in the human body. Therefore, radial artery puncture is prone to failure due to missed vessel puncture or repeated stimulation-induced arterial spasm. Even after successful radial artery puncture and sheath placement, the pushing of instruments sometimes causes radial and upper arm artery spasms, leading to intervention failure. In addition, the tortuosity of arterial access routes, such as the subclavian artery and axillary artery, during radial artery puncture is also an important reason for the failure of vascular interventions treatment.