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Técnica de alambre reflejado para la cateterización de la arteria carótida interna a través del enfoque radial
Sheth Rishabh Hitendra1, Vikas Bhatia1, Ajay Kumar1
1Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Resumen
La técnica del alambre reflejado ayuda al cateterismo de la arteria carótida interna (ICA) durante la angiografía transradial izquierda. Este método es crucial para navegar la compleja anatomía del arco aórtico, mejorando las tasas de éxito en la angiografía cerebral de diagnóstico.
Área de la Ciencia:
- Cirugía vascular Cirugía vascular.
- La neuroradiología intervencionista.
- Imágenes de diagnóstico por imágenes.
Sus antecedentes:
- El enfoque transradial izquierdo (LTRA) se utiliza cada vez más para la angiografía cerebral de diagnóstico.
- Existen desafíos para lograr el acceso bilateral a la arteria carótida interna (ICA) a través de LTRA.
- La comprensión de los factores que influyen en la canulación ICA es vital para el éxito del procedimiento.
Objetivo del estudio:
- Evaluar los factores que contribuyen a las dificultades para acceder a la arteria carótida interna (ICA) utilizando el enfoque transradial izquierdo.
- Identificar los elementos anatómicos y técnicos que afectan el éxito del cateterismo bilateral ICA.
Principales métodos:
- Estudio analítico prospectivo de un solo centro en el que participaron 32 pacientes sometidos a angiografía cerebral de diagnóstico.
- El acceso transradial izquierdo se utilizó en todos los casos.
- Evaluación de los factores que influyen en el cateterismo bilateral ICA, incluida la anatomía del arco aórtico y las técnicas de alambre guía.
Principales resultados:
- La angiografía de diagnóstico fue exitosa en el 100% de los pacientes (n=31).
- La tasa de éxito del cateterismo ICA derecho fue del 80,6% (25/31), y el ICA izquierdo fue del 77,4% (24/31).
- La técnica del alambre reflejado se requirió con frecuencia para la canulación izquierda del ICA (70,8%) y menos para el ICA derecho (36%). Las variaciones anatómicas como el tipo III o el arco aórtico bovino se correlacionan con la dificultad y el tiempo de la canulación.
Conclusiones:
- La técnica del alambre reflejado es un método eficaz para facilitar el cateterismo ICA a través del enfoque radial izquierdo.
- Morfologías específicas del arco aórtico requieren técnicas a medida para una exitosa angiografía cerebral LTRA.
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