经尺动脉径路行经皮冠状动脉介入治疗12例

Percutaneous coronary intervention through transulnar approach:12 cases report

目的探讨经尺动脉径路行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的可行性与安全性。方法选择2006年12月～2008年12月在清华大学第一附属医院住院,完成冠状动脉造影检查的1360例患者中26例经尺动脉径路行冠状动脉造影患者为研究对象,其中冠状动脉性心脏病(冠心病)稳定型心绞痛患者12例,男8例,女4例,年龄(61±10.4)岁,行经尺动脉径路行PCI治疗。另外,选择26例经桡动脉造影的患者设为经桡动脉组。所有患者均行Allen′s试验检查,记录动脉穿刺时间,冠状动脉造影时间,计算穿刺成功率和并发症的发生率。结果两组穿刺成功率比较,差异无统计学意义(χ2=0.354,P>0.05)。两组冠状动脉造影时间比较,差异无统计学意义[(20.0±3.6)minvs.(20.0±4.2)min,P>0.05]。两组并发症发生率比较,差异无统计学意义(P>0.05)。12例患者尺动脉均穿刺成功,应用6F指引导管对15条血管的17处病变行PCI治疗,均获得成功,共植入支架17枚。1例有穿刺部位淤血,无严重的出血并发症的发生。结论经尺动脉径路行PCI治疗是一种安全、有效的介入途径,是股动脉、桡动脉介入途径的补充,值得在临床实践中进一步推广应用。

Objectives To assess the clinic feasibility of percutaneous coronary intervention ( PCI) through transulnar approach. Methods We selected 26 patients received coronary artery angiography ( CAG) through transulnar approach as the transulnar group, and 26 patients received CAG through radial artery approach as radial artery group from 1 360 patients who had performed CAG. In the transulnar group, there were 12 patients with stable angina pectoris [( 61.0 ±10.4) years], including 8 males and 4 females. The acupuncture time of artery, CAG time, the success rate of ulnar acupuncture and complication rate were recorded. Results There were no differences in success rates of puncture, GAG time and complication rate between the 2 groups (P > 0.05). Twelve ulnar arteries were acupunctured successfully in 12 patients with stable angina pectoris. Seventeen lesion segements of 15 vessels in 12 patients were angioplasticized successfully by 6F guiding catheter. Conclusions PCI through transulnal approach was a safe and effective approach for coronary intervention, and may be widely used in clinical practice.