PURPOSE We aimed to evaluate the safety and feasibility of the distal transradial approach (DTRA) as a novel technique for cerebral angiography based on our institutional initial experience. METHODS We retrospectively analyzed our institutional database of consecutive diagnostic cerebral angiographies performed with DTRA from December 2018 to August 2019. Patient demographics and clinical and procedural data were recorded. RESULTS In total, 51 diagnostic cerebral angiographies in 51 patients (age, 15-83 years; mean age, 59.4 years, SD 13.5; 35 (69%) females) were performed or attempted with DTRA. Ultrasound evaluation showed that the mean inner distal radial artery diameter was significantly smaller than the mean inner forearm radial artery diameter (2.19 mm vs. 2.56 mm, P < 0.001). Cannulation via the distal radial artery was successful in 47 (92%) procedures. In the four procedures that failed, operators converted to the ipsilateral transradial approach without repositioning or redraping. Selective catheterization of the intended vessel was achieved in 64 (91%) of 70 vessels. In the remaining six, operators achieved the objective of the examination with angiography injecting from proximal and conversion to another approach was not required. One patient experienced temporary numbness around the puncture site after the procedure. No radial artery occlusion was identified in the patients who underwent ultrasound evaluation. CONCLUSION Our results demonstrate that DTRA could become a standard approach for diagnostic cerebral angiography owing to the low complication rate and the high cannulation success rate.

中文翻译：

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远端经桡动脉入路的安全性和可行性：诊断性脑血管造影的新技术。

目的根据我们机构的初步经验，我们旨在评估远端经桡动脉入路（DTRA）作为脑血管造影新技术的安全性和可行性。方法 我们回顾性分析了 2018 年 12 月至 2019 年 8 月期间使用 DTRA 进行的连续诊断性脑血管造影的机构数据库。记录了患者人口统计数据以及临床和程序数据。结果 总共有 51 名患者（年龄 15-83 岁；平均年龄 59.4 岁，SD 13.5；35 名（69%）女性）使用 DTRA 进行或尝试进行了 51 次诊断性脑血管造影。超声评估显示，桡动脉远端平均内径明显小于前臂内桡动脉平均直径（2.19 mm vs. 2.56 mm，P < 0.001）。47 例 (92%) 手术通过远端桡动脉插管成功。在四次失败的手术中，操作者转换为同侧经桡动脉入路，而无需重新定位或重新平铺。70 根血管中有 64 根（91%）实现了对预期血管的选择性插管。在其余六例中，操作者通过从近端注射血管造影来实现检查目的，并且不需要转换为另一种方法。一名患者在手术后出现穿刺部位周围暂时麻木的情况。接受超声评估的患者未发现桡动脉闭塞。结论 我们的结果表明，由于并发症发生率低、插管成功率高，DTRA 可能成为诊断性脑血管造影的标准方法。