急性心肌梗死经桡动脉途径冠脉介入治疗效果观察

Studies on the efficacy and safety of transradial approach for primary coronary angioplasty in acute myocardial infarction

目的总结急性心肌梗死(AMI)急诊经桡动脉途径行冠脉介入(PCI)治疗的疗效。方法对69例诊断为AMI患者选择右侧桡动脉为穿刺径路行PCI治疗(A组),对照组为20例AMI行经皮股动脉入路直接PCI的患者(B组)。随访术后3个月内的主要心血管事件(MACE)的发生率,包括死亡率、非致命性心肌梗死发生率、靶血管血运重建率(TVR)及3个月内复诊冠脉造影择期干预其他病变血管的手术率。结果3个月后随访结果显示,MACE发生率均无统计学意义(P>0.05);3个月内复诊冠状动脉造影及择期手术率A组明显高于B组(P<0.05)。结论急诊行经皮桡动脉入路PCI治疗AMI有一定的安全性,还不能认为其近期MACE的发生率低于经股动脉入路,但能提高冠状动脉造影的复诊及择期手术率。

Objective To evaluate the safety and efficacy of transradial approach in the treatment of acute myocardial infarction with primary percutaneous coronary intervention（PCI）.Methods A retrospective study was conducted with the data of 89 patients with acute myocardial infarction（AMI） who underwent primary PCI.Transradial approach（group A） PCI was used in 69 patients and transfemoral approach（group B） PCI was used in 20 patients.The incidence of major adverse cardiovascular events（MACE）,including death,myocardial infarction,target lesion revascularization found in 90 day,were compared between the two groups,the rates of stent thrombosis and restenosis were also compared.Results No significant differences in baseline characteristics were observed between the two groups.PCI was successfully accomplished in all patients.After 3 month follow-up,no significant difference was found in the restenosis rate（5.8% vs 10.0%） or MACE rate（14.4% vs 25.0%） between the two groups（P0.05）.Following-up coronary angiography was more frequently performed in group A than that in group B.Conclusion The transradial approach is a safe and feasible technique in patients with acute myocardial infarction treated with primary percutaneous coronary intervention.And with the higher rate of follow-up angiography and the incidence of MACE at 3 month following-up is similar to transfemoral approach.