Analysis of Right Radial Artery for Transradial Catheterization by Quantitative Angiography - Anatomical Consideration of Optimal Radial Puncture Point

作者：Fujii Toshiharu; Masuda Naoki; Toda Eri; Shima Makiyoshi; Tamiya Seiji; Ito Daiko; Matsukage Takashi; Ogata Nobuhiko; Morino Yoshihiro; Tanabe Teruhisa; Ikari Yuji^*

来源：Journal of Invasive Cardiology, 2010, 22(8): 372-376.

• transradial intervention
• radial puncture
• radial arterial bifurcation

Objectives To determine the optimal radial puncture point we analyzed the anatomy and luminal diameter of the right radial artery (RA) by quantitative angiography Background Difficulty of radial puncture has impeded the establishment of the transradial approach as the standard procedure for cardiac catheterization Methods Antegrade angiography was performed from the right brachial artery in 135 patients who underwent coronary angiography Presence and location of a bifurcation in the area of the RA puncture were analyzed Further more, inner luminal diameter of the RA was quantitatively measured We used the line between the styloid process and the ulnar styloid process (R-U line) as an anatomical reference point Results Radial arterial 61 furcation with a superficial palmar branch was angiographically observed in 66 patients (48 9%) The Inner luminal diameter was significantly larger at the proximal point to the point of bifurcation The bifurcation level was located at a median of -3 33 mm (interquartile range -5 60 to 4 69 mm) below the R-U line Radial puncture at 10 mm proximal to the R-U line could avoid bifurcation in 91 9% of all cases Mean radial, ulnar and brachial arterial inner diameters were 2 94 +/- 0 52 mm 2 51 +/- 049 mm and 453 +/- 062 mm The RA size within 10-60 mm above the R-U line was nearly invariable throughout the range Conclusion The radial puncture level should be proximal to the radial bifurcation because of its lumen size The ideal puncture point was found to be at least 10 mm proximal to the R-U line

• 出版日期2010-8