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首页> 外文期刊>Journal of endovascular therapy: an official journal of the International Society of Endovascular Specialists >A Single-Center, Randomized, Controlled Comparison of the Transradial vs Transfemoral Approach for Cerebral Angiography: A Learning Curve Analysis
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A Single-Center, Randomized, Controlled Comparison of the Transradial vs Transfemoral Approach for Cerebral Angiography: A Learning Curve Analysis

机译：颅脑血管造影跨越VS转发方法的单中心，随机受控比较：学习曲线分析

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摘要

Purpose: To compare the characteristics and learning curve of the transfemoral approach (TFA) vs the transradial approach (TRA) for cerebral angiography. Materials and Methods: Between February 2016 and April 2017, 101 patients undergoing cerebral angiography were enrolled. Fifty-one patients (mean age 67 years; 40 men) were randomized to TFA and 50 (mean age 68 years; 41 men) to TRA using a computer-generated random table. The patients' demographic and angiographic data were recorded and analyzed. The learning curve of a novice interventionist was analyzed for procedure time, puncture time, fluoroscopy time, and contrast volume as markers of technical proficiency with TFA compared with TRA. Median values are given with the interquartile range (IQR). Results: Procedure time [35 (IQR 30, 47.5) vs 31.0 (IQR 25.0, 48.9) minutes, p=0.16), fluoroscopy time [10.3 (IQR 7.6, 13.9) vs 9.4 (IQR 6.1, 17.6) minutes, p=0.70], contrast volume [105 (IQR 92, 120) vs 95.5 (IQR 90, 111.3) mL, p=0.13), radiation exposure [390.2 (IQR 268.2, 617.9) vs 455.8 (IQR 286.8, 602.3) mGy, p=0.74], and the number of catheter exchanges [1 (IQR 1, 3) vs 1 (IQR 1, 1), p=0.06] were not significantly different between the TFA and TRA groups, respectively, but puncture time was shorter with TFA than with TRA [0.6 (IQR 0.5, 1.1) vs 1 (IQR 0.6, 1.9) minutes, p=0.01]. The learning curve was steeper with TRA than with TFA in the beginning stages of training, but with increasing experience, the procedure and fluoroscopy times were better for TRA than for TFA. Training progress was made earlier in TRA. Conclusion: TRA is a reasonable alternative to TFA for cerebral angiography. TRA has a shorter learning curve for novice interventionists.
机译：目的：比较转发方法（TFA）的特征和学习曲线（TFA）对脑血管造影的颅代方法（TRA）。材料和方法：2016年2月至2017年4月，招收了101例进行脑血管造影的患者。五十一名患者（平均年龄67岁; 40名男性）被随机随机分配到TFA和50（平均68岁; 41人）使用计算机生成的随机表。记录和分析患者的人口统计和血管造影数据。分析了新手介入者的学习曲线，分析了程序时间，穿刺时间，透视时间和对比度，作为与TFA的技术熟练程度的标志物。中位数值是以狭隘的范围（IQR）给出的。结果：程序时间[35（IQR 30,47.5）VS 31.0（IQR 25.0,48.9）分钟，P = 0.16），透视时间[10.3（IQR 7.6,13.9）VS 9.4（IQR 6.1,17.6）分钟，P = 0.70 ]，对比度[105（IQR 92,120）Vs 95.5（IQR 90,111.3）mL，p = 0.13），辐射曝光[390.2（IQR 268.2,617.9）与455.8（IQR 286.8,602.3）MGY，P = 0.74 [分别在TFA和TRA组之间，导管交换的数量[1（IQR 1,3）Vs1（IQR1,1，1），p = 0.06]在TFA和TRA组之间没有显着差异，但TFA的穿刺时间较短具有TRA [0.6（IQR 0.5,1.1）VS 1（IQR 0.6,1.9）分钟，P = 0.01]。学习曲线与TRA陡峭，而不是在训练的开始阶段，但随着经验的增加，程序和透视时间比TFA更好。培训进度较早在TRA方面做出。结论：TRA是TFA用于脑血管造影的合理替代品。 TRA有一个更短的学习曲线，用于新手干预者。

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