血管干预的穿皮与开放臂接入:系统性审查和元分析
Eren Çetinel1, Mostafa Labib2, Andressa Frankowski Dagostin1
1San Raffaele University, Milan, Italy.
Annals of vascular surgery
|November 5, 2025
概括
穿皮臂接入 (PBA) 是常见的血管干预,但比开放臂接入 (OBA) 需要干预的并发症率更高. 仔细的患者选择和技术对于PBA安全至关重要.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 在外周血管干预中,手臂动脉接入是股骨接入的关键替代方案.
- 穿皮臂接入 (PBA) 越来越多地被使用,但开放臂接入 (OBA) 可能具有较低的并发症率.
研究的目的:
- 在非冠状动脉血管干预中,比较皮肤通手臂接入 (PBA) 与开放手臂接入 (OBA) 的结果.
- 为了评估PBA和OBA之间的接入部位并发症,血瘤,血栓,伪动脉瘤,神经损伤和死亡率.
主要方法:
- 观察性队列研究的系统审查和元分析.
- 在PubMed,Embase和Cochrane图书馆搜索到2025年7月.
- 使用随机效应模型计算了95%置信区间 (CI) 的聚合风险比率 (RRs).
主要成果:
- 包括6项涉及2615名患者的研究 (1954名PBA;661名OBA).
- 与OBA相比,PBA的需要干预的访问现场并发症 (RR 3.63) 和整体并发症 (RR 2.68) 的比率明显更高.
- 在血液瘤,血栓形成,伪动脉瘤,神经损伤或30天死亡率方面没有发现显著差异.
结论:
- 虽然PBA是首选的,但与OBA相比,PBA携带需要干预的访问站点并发症的风险要高得多.
- 这些发现支持对PBA进行仔细的患者选择,超声指导和细致的血液静止.
- 需要进行更大规模的前性研究,以优化手臂接入策略.
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