Trans-radial access (TRA) has been a common approach to percutaneous coronary intervention (PCI). Comparing with trans-femoral access (TFA), TRA is used as an alternative approach for PCI with less local complications, higher comfort level, and better outcome. In recent years, TRA has been paid more and more attention in peripheral vascular interventions. We reviewed recent developments in peripheral vascular intervention using TRA, with detail summary of the effectiveness, safety, limits, and future developments of it, aiming to improve the understanding and performance of TRA in interventionalists to benefit patients.
ObjectiveTo investigate the anesthesia management of transcatheter ultrasound-guided percutaneous interventional therapy for pediatric patients with congenital heart disease at a mobile surgical platform. Methods From March to July 2023, 13 patients in remote areas underwent interventional surgery on the mobile truck operating platform. The patients undergoing general anesthesia using non-tracheal intubation were collected. ResultsFinally, 8 patients received monitored anesthesia care (MAC) with local anesthesia-assisted sedation and analgesia drugs under the supervision of anesthesiologists (general anesthesia using non-tracheal intubation), due to the patients having difficulty cooperating with the surgery (young age, nervous mood, and crying), including 5 males and 3 females with an average age of 6.95±3.29 years and an average weight of 19.50±6.04 kg. There were 6 patients diagnosed with atrial septal defect, 1 patient with residual shunt after patent ductus arteriosus ligation, and 1 patient with severe pulmonary stenosis by transthoracic ultrasonography. The surgical process was smooth, analgesia was perfect, anesthesia and surgical effect were satisfactory, postoperative recovery was satisfactory, and there were no surgical or anesthesia complications. The anesthesia time was 41.53±8.62 min, the operation time was 39.88±8.52 min, and the recovery time was 41.50±14.56 min. Conclusion Transthoracic ultrasound-guided interventional surgery is a minimally invasive approach for congenital heart disease, offering the advantages of zero radiation exposure. Non-tracheal general anesthesia preserved spontaneous breathing can be safely and effectively administered to pediatric patients who cannot cooperate in mobile operating platform.