36例冠心病介入治疗后动脉径路的处理

MANAGEMENT OF THE ACCESS ARTERY FOLLOWING CORONARY INTERVENTIONS

目的：小结作者在冠心病介入治疗后处理动脉径路方面的初步经验。方法：１ａ间，采用经典方法或透视定位法穿刺股动脉前壁，在３６例冠心病患者的４７处病变行冠状动脉介入治疗。术后采用分阶段减压压迫止血。结果：术后发生穿刺部位较大血肿和假性动脉瘤各１例、微血肿３４例，未发生其它严重并发症。结论：术前识别高危患者，术中采取正确的股动脉穿刺方法以避免穿刺股浅动脉，术后在监测凝血时间下分阶段减压，可以减少冠状动脉介入治疗后的动脉径路并发症。

Objective:To describe our initial experience in the management of access artery following coronary interventions. Methods:In the last year,percutaneous transluminal coronary angioplasty and/or intracoronary stenting were performed by using a classical method or fluoroscopic location method for femoral artery puncture in 36 patients with coronary heart disease.And postprocedure staged decrease of pressure was applied for hemeostasis.Results:A major hematoma occurred at the puncture site in one patient,a pseudoaneurysm of the access artery in another, and a minimum hematoma in others without any major complications in their vascular access.Conclusion:Vascular access complications following coronary interventions may be minimized by preprocedural identification of high risk patients,a meticulous puncture technique of common femoral artery in stead of puncturing a superficial femoral artery,and postprocedural staged decrease of pressure under monitoring coagulation time.