经桡动脉入路冠状动脉介入诊疗1327例分析

Transradial Approach for Coronary Angiography and Percutaneous Coronary Interventions in 1327 cases

目的探讨经桡动脉入路介入诊疗的方法学和临床疗效,并分析其技术要点。方法回顾分析1327例次经桡动脉行冠脉造影或/和PCI患者的临床和手术情况,记录手术成功率和并发症。结果经桡动脉冠状动脉造影手术成功率为95.40%(1036/1086),经桡动脉PCI成功率为98.34%(237/241),54例经桡动脉手术失败患者改股动脉入路手术成功。术后局部血肿99例,前臂张力性血肿和桡动脉闭塞各1例,无其他并发症。结论经桡动脉冠脉造影和PCI安全有效,并发症少,不影响术后患者活动,但需要掌握一定的手术技巧和预防处理血管痉挛的经验。经桡动脉PCI宜直接选择支撑力较好的指引导管,以增加导管的后坐力和同轴性,同时对于靶病变给予充分预扩张,以手术提高成功率。

Objective To evaluate the clinical efficacy and methodology of coronary angiography and percutaneous coronary intervention via radial approach. Methods A total of 1,018 patients underwent endovascular coronary subtraction angiography and/or angioplasty interventions via radial artery for 1,327 times were retrospectively reviewed. The success rate and related complications were recorded and analyzed. Results The success rate of coronary angiography was 95. 40 % （1,036/1,086）, and among 241 times of percutaneous coronary interventfons, 237（98.34 % ） were satisfied, and the failed 54 cases were satisfied via alterative femoral artery approach. No serious complications occurred except 99 local hematomas, one severe forearm bleeding and hematoma, one arterial occlusion but without hand ischemia. Conclusions The results suggest that coronary angiography and percutaneous coronary intervention via radial approach is safe and effective, with few complications and more comfortable for patients. However, it is necessary to know well the strategy for choice of guiding catheter curves in order to obtain an easier and safer operation.