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Features and variations of a radial artery approach in southern Chinese populations and their clinical significance in percutaneous coronary intervention

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Chinese Medical Journal 2013年第6期126卷 1046-1052页

作者： LI Lang ZENG Zhi-yu ZHONG Ji-ming WU Xiang-hong ZENG Shu-yi TANG Er-wen CHEN Wei SUN Yu-han Department of Cardiology First Affiliated Hospital of Guangxi Medical University Nanning Guangxi 530021 China

Background More and more percutaneous coronary intervention were done from radial artery approach. But the great limitation of radial artery approach and main failure cause of transradial coronary intervention is smaller size and more variations of a radial artery approach. The aim of the study is to explore the features and variations of a radial artery approach in southern Chinese populations and their clinical significance in percutaneous coronary intervention. Methods A total of 1400 patients who underwent scheduled first time transradial coronary angiography between July 2007 and September 2010 were enrolled. radial arteriography was performed in all patients to detect the anatomical variations of this vessel. All patients＇ radial and ulnar artery inner diameters were measured using a computer assisted quantification method. A detailed patient history was recorded. Multivariate Logistic regression analysis was performed to evaluate the predictive value of variables （including age, gender, ethnicity, height, weight, body mass index, smoking, diabetes, hypertension and dyslipidemia） in arterial tortuosities and variations of this vessel. Results In southern Chinese populations, there were no significant differences in the diameters of the forearm arteries： the mean radial artery inner diameter was （3.04±0.43） mm in ethnic Han Chinese and （3.05±0.42） mm in ethnic Zhuang Chinese, P 〉0.05）, the mean ulnar artery inner diameter was （3.03±0.38） mm in Han Chinese and （3.05±0.36） mm in Zhuang Chinese, P 〉0.05）. It was estimated that the inner diameter of the radial artery was not smaller than a 6F Cordis sheath in 86.1% of male patients and in 57.0% of female patients, and not smaller than a 7F Cordis sheath in 59.3% of male patients and 24.9% of female patients. The factors found to positively affect the size of the radial artery were sex （bj=0.309, P 〈0.01）, weight （bj=0.103, P 〈0.01 ）, and diabetes mellitus （bj=-0.088, P 〈0.01） was found to negatively affect radial a

关键词： radial artery ulnar artery variation interventional therapy coronary heart disease

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Twelve years＇ experience and clinical results of using the radial artery for coronary revascularization

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Chinese Medical Journal 2014年第5期127卷 887-892页

作者： Cheng Zhaoyun Zhao Ziniu Quan Xiaoqiang Wang Sheng Zhao Jian Sun Junjie Hu Junlong Gao Chuanyu Song Yongping Zhengzhou University School of Basic Medicine Zhengzhou Henan 450052 China

Background The radial artery （RA） is becoming a popular conduit for coronary artery bypass grafting （CABG）,yet data reporting the long-term results are *** reported our clinical,angiographic and intravascular ultrasound findings on 93 patients who had the RA used as part of the conduit for the CABG procedures during a 12-year period from June 2001 to June *** A total of 118 radial artery conduits were harvested in 87 males and 6 females,age from 28 to 66 （mean 49.9） *** ＂intra-operative Allen＇s test＂ was developed to safeguard blood supply to the arm and hand.A ＂double-clip ＆ scissors-cut＂ technique was carried out to minimize the thermal injury to the radial artery from the *** left radial artery was used in 67 patients,the right in one,and bilateral radial arteries in 25 *** hundred and twenty-two out of 272 distal anastomoses （44.9％） were constructed with radial arteries,with an average of 2.9 grafts per patient （range 2-6）.Results Follow-up angiography and intravascular ultrasound study at 3-139 postoperative months （mean 59 months） revealed a 93.1％ RA *** sign occurred in one patient in whom the RA was directed to a big right coronary artery with a stenosis of around 50％.The patency for the internal mammary artery was 96.4％.Conclusions The RA is an excellent conduit that broadens the options for total arterial CABG *** graft patency could be achieved through careful harvesting techniques and choice of proper target coronary vessels.

关键词： coronary artery disease total arterial bypass radial artery Allen's test patency

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radial artery access site complications during cardiac procedures,clinical implications and potential solutions: The role of nitric oxide

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World Journal of Cardiology 2020年第1期12卷 26-34页

作者： Emma M Coghill Timothy Johnson Russell E Morris Ian L Megson Stephen J Leslie Free Radical Research Facility Division of Biomedical SciencesUniversity of the Highlands and IslandsInverness IV23JHUnited Kingdom Johnson Matthey Technology Centre Blount’s CourtSonning CommonReading RG49NHUnited Kingdom School of Chemistry University of St.AndrewsSt Andrews KY169STUnited Kingdom Department of Cardiology NHS HighlandInverness IV23UJUnited Kingdom

Percutaneous coronary intervention for the treatment of coronary artery disease is most commonly performed in the UK through the radial artery,as this is considered to be safer than the femoral ***,despite improvements in technology and techniques,complications can *** most common complication,arterial spasm,can cause intense pain and,in some cases,procedural *** incidence of spasm is dependent on several variables,including operator experience,artery size,and equipment *** antispasmolytic cocktail can be applied to reduce spasm,which usually includes an exogenous nitric oxide(NO)donor(glyceryl trinitrate).NO is an endogenous local vasodilator and therefore is a potential target for anti-spasm ***,systemic administration can result in unwanted side-effects,such as hypotension.A method that adopts local delivery of NO might be *** review article describes the mechanisms involved in radial artery spasm,discusses the advantages and disadvantages of current strategies to reduce spasm,and highlight the potential of NO-loaded nanoporous materials for use in this setting.

关键词： radial artery Cannulation Spasm Nitric oxide Vasodilation Nanoporous material

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Effect of pulsatile perfusion during cardiopulmonary bypass in terms of radial artery sphygmogram

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Journal of Traditional Chinese Medicine 2014年第6期34卷 673-677页

作者： Zhifeng Zhang Jiatuo Xu Enyuan Zhu Qi Zhang Lu Yu Yongbing Qiu Jianguo Tang Zhaofu Fei Xin Li Liping Tu Chouping Han Ying Liu Zhen Guo Changle Zhou Meiyu Shi Yingxin Qian Yimin Bao Xinming Ji Basic Medical Science School Shanghai University of Traditional Chinese Medicine Department of Microelectronics Fudan University Department of Cardiopulmonary Bypass Shanghai Chest Hospital Affiliated with Shanghai Jiaotong University

OBJECTIVE: To investigate a quantitative method for using radial artery pulse waveforms to assess the effect of pulsatile flow during cardiopulmonary bypass(CPB).METHODS: A total of 34 adults with heart disease who underwent open-heart surgery between April2010 and January 2011 were randomized into a pulsatile perfusion group(n=17) and a non-pulsatile perfusion group(n=17). radial arterial pulse waveforms of pulsatile and non-pulsatile perfusion patients were observed and compared before and during ***: No pulse waveform could be detected at patients' radial artery in both groups when the aorta was cross-clamped. Pulse waveforms could be detected at pulsatile perfusion patients' radial artery, but could not be detected at non-pulsatile perfusion patients' radial artery during CPB. Additionally, patients' pulse waveforms during pulsatile perfusion were lower than those before the ***: Our findings indicate that radial artery sphygmogram can be used as a valid indicator to evaluate the effectiveness of pulsatile perfusion during CPB.

关键词： Cardiopulmonary bypass Pulsatileflow radial artery Pulse waveforms Sphygmogram

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Influence of Puncture Site on radial artery Occlusion After Transradial Coronary Intervention

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Chinese Medical Journal 2016年第8期129卷 898-902页

作者： Xi-Le Bi Xiang-Hua Fu Xin-Shun Gu Yan-Bo Wang Wei Li Li-Ye Wei Yan-Ming Fan Shi-Ru Bai Department of Cardiology The Second Hospital of Hebei Medical University Shijiazhuang Hebei 050000 China

Background：The risk of radial artery occlusion （RAO） needs particular attention in transradial intervention （TRI）.Therefore,reducing vascular occlusion has an important clinical *** aim of this study was to determine the appropriate puncture site during TRI through comparing the occurrence of RAO between the different puncture sites to reduce the occurrence of RAO after ***：We prospectively assessed the occurrence of RAO in 606 consecutive patients undergoing *** occlusion was evaluated with Doppler ultrasound in 2 days and 1 year after the *** factors for RAO were evaluated using a multivariate model ***：Of the 606 patients,the RAO occurred in 56 *** with TRI at 2-5 cm away from the radius styloid process,the odds ratio （OR） for occlusion risk at 0 cm and 1 cm were 9.65 （P =0.033） and 8.90 （P =0.040）,*** RAO occurred in the ratio of the arterial diameter to the sheath diameter ≤1 （OR =2.45,P =0.004）.Conclusion：Distal puncture sites （0-1 cm away from the radius styloid process） can lead to a higher rate of RAO.

关键词： Percutaneous Coronary Intervention Puncture Site radial artery Risk Factors

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Role of radial artery in total arterial myocardial revascularization in coronary bypass surgery

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Chinese Medical Journal 2008年第3期121卷 200-204页

作者： CHEN Xu-jun ZHANG Yong CHEN Xin FENG Wen-hui LI Da-lian LI Hong-wei Department of Cardiac Surgery Cardiovascular Center BeijingFriendship Hospital Capital Medical University Beijing 100050China Department of Cardiac Surgery Beijing Military General HospitalBeijing 100700 China Department of Thoracic and Cardiovascular Surgery Nanjing FirstHospital Nanjing Medical University Nanjing Jiangsu 210006China

Background Total arterial revascularization （TAR） was widely utilized in coronary artery bypass grafting （CABG） as a result of its better long-term effect compared with vein grafts. Of the arterial conduits, radial artery （RA） gained popularity for its easy availability and reported long-term patency. Thus, the objective of this study was to investigate the effect of RA in TAR in CABG. Methods From January 2000 to December 2006, 85 patients （56 male and 29 female） at a mean age of 57.0 ± 5.2 years, underwent TAR in CABG. RA and left internal mammary artery （LIMA） with composite Y or T and sequential grafting techniques were used. Post-operative complications were recorded and follow-up was performed. Results Eighty-five LIMA and 149 RA grafts including 21 single and 64 bilateral RA were collected. A total of 87 distal anastomoses were done with the LIMA and another 152 were done with the RA, with the mean number of distal anastomosis per patient of 2.81 ± 0.47. The proximal RA ends were anastomsed directly to the aorta in 140 grafts with Y or T graft off in situ LIMA in 9, Y or T graft off RA in 9. The distal end was anastomsed to right coronary artery system in 92 to obtuse margina in 46, to diagonal in 19 and to ramous intermedius in 5. Nine sequential anastomoses were performed with RA. Nine composite Y or T grafts were constructed with RA and LIMA while another 9 were constructed with RA and RA. One （1.2%） patient died, 3 patients （3.5%） experienced acute renal failure and 2 （2.4%） developed stroke. All patients were still alive and no patient had evidences of newly occurred myocardial infarction or angina after a mean follow-up of 36.5 ＋ 4.1 months （6-67 months）. Postoperatively at 6 month, mean left ventricular ejective fraction was increased to 0.49 ±0.09, compared with that of 0.43 ± 0.11 preoperatively （P=-0.027）. Postoperative mean New York Heart Association class was 2.5±0.5, compared with that of 3.0±0.4 preoperatively （P=-0.003）. Conclusions TAR w

关键词： radial artery coronary artery bypass total arterial revascularization

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Pseudoaneurysm with Median Nerve Injury Caused by Right radial artery Puncture:A Case Report

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Cardiovascular Innovations and Applications 2021年第1期5卷 219-224页

作者： Yachao Li Zengming Xue He Ma Wei Zhang Shaoping Nie Changsheng Ma Department of Cardiology People’s Hospital of Langfang CityLangfang065000 HebeiPeople’s Republic of China Department of Ultrasound People’s Hospital of Langfang CityLangfang065000 HebeiPeople’s Republic of China Department of Orthopedics People’s Hospital of Langfang CityLangfang065000 HebeiPeople’s Republic of China Emergency Department Beijing Anzhen HospitalCapital Medical University100029 BeijingPeople’s Republic of China Department of Cardiology Beijing Anzhen HospitalCapital Medical University100029 BeijingPeople’s Republic of China

Background:Pseudoaneurysm with median nerve injury is a serious complication of radial artery *** is very important to summarize the prevention and treatment experience of this complication through case *** report:A 66-year-old woman was admitted to the hospital because of‘‘paroxysmal chest tightness and suffocation for 5 days.”Coronary angiography was *** insertion of the arterial sheath,the patient experienced severe pain in the right forearm,which radiated to the *** puncture sheath did not return blood after the sheath core was *** sheath was removed and local compression was used to stop *** was no obvious bleeding at the puncture point,and the compression was removed 6 hours after the *** swelling and increased tension were seen in the right *** the 1-week follow-up she exhibited swelling,high local tension,small blisters,and bluish-purple skin of the right forearm,with an acceptable right radial artery *** had severe pain in the affected limb,which radiated to the thumb,index fi nger,and middle fi *** discussion:We discuss the causes of and treatment measures for pseudoaneurysm with median nerve injury caused by radial artery puncture.

关键词： Puncture radial artery median nerve complications

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Efficacy of patient-controlled hydromorphone analgesia in those undergoing uterine fibroid artery embolization via the right radial artery

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Journal of Interventional Medicine 2023年第1期6卷 20-23页

作者： Yanli Wang Yi Zhao Miao Xu Yanling Wang Songmei Li Yi Fang Xinwei Han Kai Zhang Department of Interventional Radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou450052China Department of Interventional Radiology The Third Affiliated Hospital of Zhengzhou UniversityZhengzhou450052China

Objective: To evaluate the efficacy and safety of patient-controlled analgesia(PCA) with hydromorphone as perioperative analgesia during uterine artery embolization(UAE) via the right radial *** and methods: A total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone(10 mg) was dispensed into a 100 ml PCA pump with normal saline. Pump administration was initiated 15 min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 h after the procedure. Side effects were also ***: Thirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were ***: Patients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.

关键词： Uterine leiomyoma Uterine artery embolization(UAE) radial artery Analgesia Hydromorphone

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radial artery and Saphenous Vein Grafts in Coronary artery Bypass Surgery Comparison in Terms of Patient Symptoms

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World Journal of Cardiovascular Surgery 2014年第4期4卷 43-46页

作者： Tugra Gencpinar Koray Aykut Gokhan Albayrak Umut Ayoglu Muzaffer Yilmaz Kadir Sagdic Mustafa Emmiler Cardiovascular Surgery Clinic Education and Research HospitalAntalyaTurkey Department of Cardiovascular Surgery Izmir UniversityIzmirTurkey

Background: The aim of this study is to compare radial artery with saphenous vein grafts which are widely used for coronary bypass, from views of patients’ satisfaction and postoperative findings. Methods: 42 isolated coronary bypass (CABG) patients performed during November 2012-April 2013 are included in the study. 30 days after the operation, in patients who had both RA and SV removal made responses to a questionnaire form which included 6 questions about symptoms of extremity. Results: After analyzing the responses and physical examination, there was no difference in terms of quality of life and usefulness of the extremity for daily use between two grafts. 2 patients (2%) have wound infection on the saphenous vein incision and additional surgical procedure was performed and a scar tissue has occurred. There was no statistically significance between uncomfortable symptoms and demographic data. Conclusion: Our study suggested that RA graft using showed a bit more comfortable and suitable effect against SV in our patients. We think that radial arterial grafts should be used more widely in coronary surgery with selected patients.

关键词： radial artery Saphenous Vein Coronary artery Bypass Grafting

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Assesment of radial artery by Means of Doppler Ultrasonography and Soft Tissue Roentgenogram in End-Stage Renal Disease Patients

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World Journal of Cardiovascular Surgery 2014年第1期4卷 7-12页

作者： Ahmet Feyzi Abacilar Umit Duman Omer Faruk Dogan Izmir Sifa Hospital Sanayi Caddesi No.7BornovaIzmirTurkey Istanbul American Hospital Department of Cardiovascular SurgeryIstanbulTurkey Adana Numune Education and Training Hospital Department of Cardiovascular SurgeryAdanaTurkey

Background: Although the radial artery (RA) is mostly selected for the creating of arterio-venous fistula (AVF) in end-stage renal disease patients (ESRDP), it still represents a suitable site to simply assess systemic calcification. Our goal of this study was to research the RA before the arteriovenous fistula creation in ESRDP and evaluate the risk factor determinants. Material and Methods: The RA has been determined to estimate vascular calcification in 67 ESRDPs on dialysis by doppler ultrasonography (USG). If there was any pathologic conditions, direct examination of the forehand soft tissue roentgenograms as a simply method was made. Preoperative spectral Doppler sonography measured radial artery peak systolic velocity during tight fist clenching for 3 minutes and after fist relaxation. Vessel diameters and peak systolic velocity were assessed for predictive value based on subsequent fistula adequacy. RA calcification was scored from Grade 0 which was defined as no calcification to Grade 4 which was described as severe calcification from proximal to distal end of RA. Results: Doppler USG has shown that the major or minor RA calcification was detected in 11 patients (16.5%). In these patients, direct roentgenogram also demonstrated RA calcific disease. Total and LDL cholesterol levels, gender and smoking status have no influence on calcification scores. When the dialysis periods are concerned, there was no correlation with the RA calcification. Serum calcium and phosphate levels, rather than calcium-phosphate products, and age were correlated with high calcification scores. The highest prevalence of RA calcification was also found in diabetic group. Conclusion: Our data indicate that RA calcification is highly prevalent among ESRDP, with the highest prevalence among diabetics. The RA was used as an A-V fistual creation in ESRDPs, which may be risky since the calcification percentage is higher. Therefore, a simple roentgenographic survey may help to identify pat

关键词： radial artery Calcification End-Stage Renal Failure Patients

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