Vasküler Giriş Yeri: Transradial-Transfemoral Yaklaşım
Özet
Perkütan koroner girişimlerde (PKG) kullanılan vasküler erişim yolları, işlemin güvenliği, başarısı ve hasta sonuçları üzerinde belirleyici rol oynamaktadır. Günümüzde transfemoral (TF) ve transradial (TR) yaklaşımlar en sık tercih edilen yöntemler olup, her birinin kendine özgü avantaj ve sınırlılıkları bulunmaktadır. Transfemoral erişim kolay uygulanabilirliği ve geniş lümenli kateter kullanımına olanak tanıması nedeniyle uzun yıllar standart yaklaşım olmuştur; ancak kanama ve vasküler komplikasyon oranlarının yüksekliği önemli bir kısıtlılıktır. Buna karşın transradial erişim, düşük komplikasyon oranları, erken mobilizasyon ve hasta konforu ile öne çıkmakta ve güncel kılavuzlarda birinci seçenek olarak önerilmektedir. Brakiyal, ulnar, aksiller, distal radial (snuffbox) ve pedal arter gibi alternatif yollar ise özellikle özel hasta gruplarında kullanılabilecek seçeneklerdir. Ultrasonografi eşliğinde ponksiyon ise tüm girişimlerde komplikasyonları azaltan modern bir yöntem olarak ön plana çıkmaktadır. Bu bölümde, farklı vasküler giriş yolları uygulama teknikleri, klinik avantaj ve dezavantajları, olası komplikasyonları ve kılavuz temelli öneriler ışığında değerlendirilmektedir.
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