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桡动脉(radial artery,RA)提取于20世纪70年代初由Carpentier首先应用于临床,约25％的桡动脉发生痉挛,早期临床效果不佳。20世纪90年代采用无接触技术(no-touch technique)和使用钙离子拮抗剂,5年通畅率提高到84.4%～91.9%,仅次于内乳动脉,开始广泛应用,成为重要的冠状动脉移植物。应用桡动脉行冠状动脉旁路移植可显著改善远期疗效,减少心脏相关事件发生率。由于前臂神经、肌肉结构较复杂,桡动脉易于痉挛,如果提取方法不当,将造成桡动脉痉挛,血流量下降,甚至是无血流,影响手术效果。本文着重介绍桡动脉的应用解剖和提取技术。
Radial artery (RA) extraction was first applied to the clinic by Carpentier in the early 1970s. About 25% of the radial arteries were spasm. The early clinical results were poor. In the 1990s, with no-touch technique and calcium antagonist, the 5-year patency rate increased to 84.4% -91.9%, which was second only to the internal mammary artery and became widely used as an important coronary artery transplant Things. Application of radial artery coronary artery bypass grafting can significantly improve the long-term efficacy and reduce the incidence of heart-related events. Due to the forearm nerve, muscle structure is more complex, prone to spasm radial artery, if the improper extraction method will result in radial spasm, decreased blood flow, or even no blood flow, affecting the surgical results. This article focuses on the application of radial artery anatomy and extraction techniques.