ABSTRACT
Distal transradial access for vascular interventions has gained ground recently. While the novel approach is associated with reduced radial artery occlusion and faster hemostasis, it could be related with prolonged procedural time, higher crossover rate and increased radiation, comparing to conventional transradial approach. Whether the radiation is increased in the procedures performed by the novel approach remains unambiguous. In the specific article, we aim to review the current literature and to propose possible explanations for this phenomenon. Could radiation be the Achilles’ heel of distal transradial artery access?
ABSTRACT
The anatomical snuffbox is a small triangular area situated in the radial part of the wrist, often used to perform clinical and surgical procedures. Despite the frequency with which this area is used, there is scarce information in literature about its details. The objective of this study is detailed knowledge of the anatomical snuffbox's anatomy and its components, the reported alterations at this portion, besides the clinical uses and significance of this area.
La tabaquera anatómica, es una pequeña área triangular ubicada en la parte radial de la muñeca utilizada a menudo para realizar procedimientos clínicos y quirúrgicos. A pesar de la frecuencia con la que se utiliza esta zona, escasea la información acerca de sus detalles en la literatura. El objetivo de este estudio es conocer con detalle la anatomía de la tabaquera anatómica y sus componentes, las alteraciones reportadas a ese nivel, y los usos e importancia clínica de esta región.
Subject(s)
Humans , Radial Artery/anatomy & histology , Radial Nerve/anatomy & histology , Wrist/anatomy & histology , Anatomic Variation , Wrist/blood supply , Wrist/innervationABSTRACT
This study concerns 110 patients who were underwent anatomical snuffbox arteriovenous fistula at Department of Surgery, Holy Family Hospital, College of Medicine, The Catholic University of Korea, from January 1995 to December 1997. We analysed the overall and success patency rate between diabetic and non-diabetic patients. The results obtained are as follows: 1) 52 operations were performed on male patients and 58, on females. And mean age was 51 years. 2) Average follow-up period was 19 months. 3) Early failure rate of all cases was 17 cases (15%), 2 cases (6%) in diabetic patients and 15 cases (9.7%) in non-diabetic patients. 4) Overall patency rates of all patients were 76.6, 72.0, 68.8 and 64.9% at 6, 12, 18 and 24 months and success patency rates were 90.7, 85.2, 81.4 and 76.8% after creation of anatomical snuffbox arteriovenous fistulas. 5) Overall patency rates of diabetic patients were 78.8, 74.8, 74.8 and 59.8% at 6, 12, 18 and 24 months and success patency rate were 83.4, 79.4, 79.4 and 63.5%. 6) Overall patency rate of non-diabetic patients were 75.9, 71.0, 66.6 and 66.6% at 6, 12, 18 and 24 months and success patency rate were 94.5, 88.4, 83.0 and 83.0%.