经前臂静脉径路行右心导管检查和肺动脉造影的可行性研究

Feasibility and safety of right heart catheterization and pulmonary angiography through the antebrachium veins

目的探讨经前臂静脉径路进行右心导管检查及肺动脉造影的可行性和安全性。方法本研究为多中心横断面临床研究，连续观察68例符合入选标准的疑诊肺血管病患者，采用前臂静脉径路进行右心导管检查及肺动脉造影。结果经前臂静脉径路穿刺置入鞘管成功率为97.1％，成功完成右心导管检查和肺动脉造影成功率为91.2％。本组病例中有6例患者经前臂静脉径路未能完成右心导管检查，其中2例前臂静脉细小，3例患者存在左侧锁骨下静脉纤细，1例有前臂注射毒品史导致浅表静脉允盈差。仅有1例患者发生腋静脉分支出血和局部血肿的并发症。结论经前臂静脉径路进行右心导管检查操作简便，并发症发牛率低，术后患者舒适度高，建议作为有心导管和肺动脉造影可选的检查径路。

Objective To investigate the feasibility and safety of right heart catheterization through the antebraehium veins. Methods A total of 68 consecutive patients suspected with pulmonary vascular diseases underwent standard right heart catheterization and pulmonary angiography through the antebrachium veins were enrolled in this muhicenter, cross-sectional study. Results The rate of successfully inserting the sheath into antebraehium veins was as high as 97.1% （ 66/68 ） and the rate of successfully performing right heart catheterization or pulmonary angiography through vascular access of antebraehium veins was 91.2% （62/68）. The reasons of unsuccessful inserting the catheter to the right heart were due to the abnormality of antebrachium veins （2 cases ） or stenosis of subclavian vein （3 cases ） or unsatisfactory engorging of antebraehium veins since the history of drug injection （ 1 case）. Haemorrhage of branch of axillary vein was the only adverse event occurred in one patient. Conclusion It is a safe, convenient and well-tolerant option to perform right heart catheterization and pulmonary angiography through the vascular access of antebrachium veins.