经肱动脉途径介入治疗冠状动脉复杂病变研究

Transbrachial approach for treating complex coronary lesions

目的探讨经肱动脉途径行冠状动脉腔内成形术治疗复杂冠状动脉病变的可行性。方法将100例患者随机分为经肱动脉途径行经皮冠脉介入治疗(PCI)组(n=50例)和经股动脉途径行PCI组(n=50例)。对比两组手术成功率、手术和曝光时间、平均住院时间、穿刺部位并发症和费用。结果经肱动脉途径和股动脉的手术成功率均为98.00%。两组的透视时间分别为(7.89±3.51)min和(7.88±3.43)min,手术时间分别为(42.9±9.2)min和(42.5±9.1)min,两组比较无统计学差异(P>0.05)。与经股动脉途径组相比,经肱动脉组的穿刺部位并发症较低(P<0.05),平均住院时间较短(P<0.05),平均住院费用也较低(P<0.01)。结论对于不适合经桡动脉途经治疗的复杂冠状动脉病变,可以首选经肱动脉途径PCI治疗。

Objective To investigate the feasibility of treating complex coronary lesions with percutaneous transluminal coronary angioplasty by transbrachial approach. Methods The patients （n=lO0） were randomly divided into group of percutaneous coronary intervention （PCI） by transbrachial approach （transbrachial group, n=50） and group of PCI by transfemoral approach （transfemoral group, n=50）. The success rate, PCI duration, fluoroscopic duration, average hospital time, complications at site of puncture and hospital costs were compared between two groups. Results The success rate of two approaches all were 98.00%. The fluoroscopic duration was respectively （7.89 ± 3.51） min and （7.88 ± 3.43） min, PCI duration was respectively （42.9 ±9.2） min and （42.5 ± 9.1） min in two groups （P〉0.05）. Compared with transfemoral group, the complications at site of puncture were less （P〈0.05）, average hospital time was shorter, and average hospital costs were lower （P〈0.01） in transbrachial group. Conclusion For ACS patients being not suitable to transradial approach, transbrachial approach is the first selection for treating complex coronary lesions.