经皮穿刺桡动脉冠状动脉腔内成形术和支架术123例报告

Experience of Transradial Coronary Angioplasty and Stenting in 123 Patients

目的：探讨经桡动脉进行冠状动脉介入治疗的可行性、安全性和介入材料的选择。 方法：选择经桡动脉冠状动脉造影成功的１２３例冠心病患者为研究对象。８８处左冠状动脉病变中，５６例使用了Ｊｕｄｋｉｎｓ左冠导管，１６例使用了Ｖｏｄａ左冠导管门４例使用了Ａｍｐｌａｔｚ左冠导管，另２例分别使用了人Ａｍｐｌａｔｚ左冠导管和ＭＡＣ导管。４５处右冠状动脉病变中，２６例使用了Ｊｕｄｋｉｎｓ右冠导管，１２例使用了Ａｍｐｌａｔｚ右冠导管，６例使用了Ａｍｐｌａｔｚ左冠导管，ｌ例使用了ＭＡＣ指引导管。 结果：共对１２３例患者的１３８处病变（左主干１例，左前降支５３例，左回旋支３４例，右冠状动脉４５例，冠状动脉旁路移植血管５例）进行了治疗。其中，对４处病变进行了单纯的经皮冠状动脉腔内成形术（ＰＴＣＡ），６５处进行了直接支架术，６９处进行了ＰＴＣＡ加支架术。１２３例中１１９例获得成功（９６．７％）。支架置入前后血管平均狭窄程度分别为８３．４％和 ５．８％。共置入支架 １３１枚，其中 ２．５ ｍｍ的１１枚，２．７５ ｍｍ的 ５枚，３．０ ｍｍ的 ５０枚，３．５ｍｍ的 ５１枚，４．０ ｍｍ的 １３枚，５ｍｍ的１枚。 结论：经桡动脉进行冠状动脉介入治疗是一种安全?

Objective: To evaluate the feasibility and safey of transradial coronary angioplasty and stenting. Methods: ①Subjects: coronary angioplasty and stenting were carried out in 123 patients with ischemic heart dis- ease. Their average age was (64. 2± 9. 4)years. ②Choice of guiding catheter: 5F guiding catheter was ed in 68 patients, 6F guiding catheter in 54 patients, and 8F guiding catheter in one patient. Left Judkins catheter was used in 56 cases, left Voda catheter in 16 ase and left Amplatz catheter in 14 cases for 88 left coronary lesions; right Judkins catheter in 26 cases, right Amplatz catheter in 12 cases and left Amplatz catheter in 6 cases for 45 right coronary lesions. Results: 138 lesions of 123 patients were treated, 1 lesion in left main coronary artery, 53 in left anterior descending artery 34 in circumflex, 45 in right coroary artery and 5 in coronary artery bypass grafts and internal mammary grafts.Among 138 lesions, 4 lesions were only dilated with balloon, 65 lesions wee directly stented, and 69 lesions were dilat- ed with balloon and then stented. Success was obtained in 96. 7% cases. Averag stenose rate was 83. 4% before stenting and 5. 8% after stenting.A total of 131 stents wer implanted, 11 stents in 2. 5mm, 5 stents in 2. 75mm, 50 stents in 3 .0 mm, 51 stents in 3. 5mm, 13 stents in 4. 0mm and one stent in 5mm. Conclusions: Transradial coronary angioplasty and stenting were both feasible and safe with a very low risk of local compli- cation and more comfort for patients.