不同类型5F共用型造影导管在经桡动脉径路冠状动脉造影中的应用

Coronary angiography by transradial approach with 5F universal catheter

目的 探讨使用较小直径 (5F)共用型造影导管经桡动脉径路行诊断性冠状动脉造影的可行性。方法 选择 2 0 0 1年 5月至 2 0 0 4年 4月间在阜外医院行择期经桡动脉径路冠状动脉及左心室造影患者 30 94例 ,其中男性 2 396例 ,女性 6 98例 ,平均年龄 5 6 1± 9 8(30～ 81)岁。入选患者按其造影时首先选用可供左、右冠状动脉插管的 5F共用型造影导管分为共用型导管Ⅰ组 (Mitsudo型 ,日本Hanako公司产品 ,n =985 )、共用型导管Ⅱ组 (Terumo型 ,日本Terumo公司产品 ,n =10 2 4 )和共用型导管Ⅲ组 (Medtronic型 ,美国Medtronic公司产品 ,n =10 85 )。比较上述三组间手术成功率、冠状动脉及左心室造影平均手术操作时间和X光透视时间。结果 (1)共用型导管Ⅰ组、Ⅱ组和Ⅲ组经桡动脉径路行冠状动脉及左心室造影成功率分别为 98 4 %、98 0 %和 96 0 % ,Ⅰ组和Ⅱ组间差异无统计学意义 ,但高于Ⅲ组 (P <0 0 5 )。 (2 )共用型导管Ⅰ组的冠状动脉及左室造影平均手术操作时间和X光透视时间分别为 (17 9± 5 8)min和 (4 8± 1 8)min ,共用型导管Ⅱ组为 (18 2± 5 5 )min和(5 0± 1 7)min ,而Ⅲ组为 (2 1 1± 7 2 )min和 (5 2± 1 9)min ,均明显长于前两组 (P <0 0 5 )。结论(1)

Objective To probe the efficacy and feasibility of the transradial approach for diagnostic coronary angiography with 5F universal catheter. Methods Transradial coronary angiography was performed in 3094 consecutive patients,2396 men and 698 women,aged 30-81 years,mean age (56.1±9.8) years, from July 2000 to April 2004. Patients were divided into 5F improved Terumo catheter group (improved Terumo group, n=985), 5F universal Terumo catheter group(Terumo group, n=1024) and 5F universal Medtronic catheter group(Medtronic group, n=1085).The procedure success rate, duration of operation and fluoroscopy between groups were compared. Results The procedure success rate was 98.4% in improved Terumo group, 98.0% in Terumo group, and 96.0 % in Medtronic group,respectively. The success rate was higher in improved Terumo group than in Medtronic group (P<0.05) .The average duration of operation and fluoroscopy in improved Terumo group was (17.9±5.8) min and (4.8±1.8) min, in Terumo group was (18.2±5.5) min and (5.0±1.7) min , but (21.1±7.2) min and (5.2±1.9) min in Medtronic group .There were significant differences among group (P<0.05). Conclusions ^(1)Transradial coronary angiography with small diameter universal catheter is safe and easy to perform with a higher success rate and allow earlier patient ambulation , and should be strongly encouraged and recommended. (2)Option of angiographic catheter plays a key role in the safety, efficacy and quality of transradial coronary angiography. Seemingly,the improved Terumo group was excellent and shoud be popularized. [