经桡动脉冠状动脉造影术和血管成形术的可行性和安全性分析

Study on the feasibility and safety of transradial coronary angiography and angioplasty

目的探讨经桡动脉行冠状动脉造影术和血管成形术的可行性、安全性和成功率。方法回顾我院1495例经桡动脉行冠状动脉造影术和694例经桡动脉行冠状动脉血管成形术患者,并以406例经股动脉行冠状动脉血管成形术患者作为对照,记录患者基本情况和临床资料。结果经桡动脉行冠状动脉造影术的成功率为95.3%,经桡动脉行冠状动脉血管成形术的成功率为97.3%。经桡动脉冠状动脉血管成形术组手术成功率与经股动脉组(96.7%)差异无统计学意义(P>0.05),但手术操作时间、X线照射时间较经股动脉组长(54.9±15.2min比40.1±10.6min,P<0.05;20.2±8.3min比15.1±6.5min,P<0.01)、造影剂用量较经股动脉组多(165.2±30.7mL比143.5±25.1mL,P<0.01)。大部分(94.5%)患者未出现任何并发症。结论经桡动脉行冠状动脉造影术和血管成形术虽然手术操作时间和X线照射时间长,造影剂用量多,但手术成功率高、并发症少,具有临床可行性和安全性。

Objective To assess the safety and success rate of coronary angiography and angioplasty by transradial approach. Methods We retrospectively reviewed the data of 1 495 patients who had received transradial angiography and 694 patients who had received transradial coronary angioplasty. We compared the data of the transradial coronary angioplasty group with a matched transfemoral coronary angioplasty group which included 406 patients. Results The success rate of transradial coronary angiography was 95.3% and that of the transradial coronary angioplasty group was 97.3% （ P 〉 0. 05 ）. The duration of procedure, fluoroscopy time and amount of contrast media consummed in the transradial angioplasty group were more than those in the transfemoral angioplasty group （54. 9 ± 15.2 min vs 40. 1 ± 10. 6 min, P 〈 0. 05 ;20. 2 ± 8.3 minvs 15.1 ±6.5 rain and 165.2 ±30.7 mL vs 143.5 ±25.1 mL, both P 〈0.01）. Conclusion Transradial approach needs longer procedural time, conger fluoroscopy time and more contrast media, but its success rate is high and complications are rare. Transradial approach is feasible and safe.