Transradial cerebral angiography in elderly patients and relevant morphometric parameters of the aortic arch
Objective To explore the benefits of transradial diagnostic cerebral angiography in elderly patients and its correlation with morphometric parameters of the aortic arch.Methods Clinical data and aortic arch CTA imaging parameters of patients who underwent cerebral angiography at the Department of Neurosurgery,Beijing Hospital,between May 2022 and April 2023 were retrospectively analyzed.The study aimed to compare the time taken for angiography via radial artery access in elderly patients versus younger patients,as well as via femoral artery access,and to evaluate the associated aortic arch morphology parameters.Results A total of 101 patients'data were analyzed,with 67 males(66.3％)and an average age of 63.4±12.0 years.Among them,69 patients(68.3％)were aged 60 and above.The arterial approach for 44 patients(43.6％)was radial,while 57 cases(56.4％)used the femoral artery approach.In the elderly group,14 cases(20.6％),31 cases(45.6％),and 23 cases(33.8％)had type Ⅲ aortic arch,respectively.For younger patients,17 cases(53.1％),12 cases(37.5％),and 3 cases(9.4％)fell into these categories.The distribution difference was statistically significant(x2=12.765,P=0.002).Elderly patients had a larger aortic arch width angle compared to younger patients(106°±12°and 100°±12°,t=2.334,P=0.022).The time for whole-brain angiography via radial artery was shorter for elderly patients than via femoral artery(39.8 ±29.5 minutes and 52.2±28.4 minutes,respectively,t=1.845,P=0.070).In young patients,there was no significant time difference between the two approaches(42.3±30.4 minutes for radial artery and 34.6±11.2 minutes for femoral artery,t=1.026,P=0.313).In the type Ⅱ aortic arch group,the average times for transradial and transfemoral approaches were 38.1±21.7 minutes and 46.7± 32.2 minutes,respectively(t=1.020,P=0.314).The average times for the type Ⅲ aortic arch group were 41.9±37.3 minutes and 48.9±20.7 minutes,respectively.Correlation analysis revealed a significant negative correlation between the duration of radial artery access and the distance from the origin of the innominate artery to the left subclavian artery(Pearson correlation coefficien(r=-0.372,P=0.014).Conclusions In elderly patients,particularly those with type Ⅱ or Ⅲ aortic arch or a wide aortic arch,diagnostic cerebral angiography using transradial access is preferable to femoral access.The distance between the innominate artery and the left subclavian artery origin could impact the duration of the procedure.
NETL
NSTL
万方数据
