经桡动脉路径血管内支架成形术在弓上动脉重度狭窄中的应用

Application of transradial stenting in the treatment of severe stenosis of superior arch artery

目的探讨经桡动脉路径替代经股动脉路径行弓上动脉血管内支架成形术的安全性、可靠性、有效性。方法 52例均为经桡动脉路径施行弓上动脉血管内支架成形术。其间,观察、记录并分析患者的穿刺结果、手术结果、手术持续时间、术中出血量、术后并发症、术后卧床时间、平均住院时间。结果穿刺和手术成功率均为100%。73.08%(38/52)的病人手术持续时间≤30min,84.62%(44/52)术中出血量在10mL以内。术后并发症有穿刺点出血和穿刺部位血肿两种,发生率17.31%(9/52);总并发症发生率无性别与年龄的差异(P>0.05)。术后不需使用血管缝合器,可立即下床活动。患者平均住院时间无增加。结论经桡动脉路径弓上动脉血管内支架成形术,临床上安全、可靠、效果好,可作为经股动脉路径的替代路径。

Objective To investigate the safety,reliability,and effectivity of transradial supra aortic arteries stenting as an alternative of transfemoral access. Methods All 52 patients underwent endovascular stent of supra aortic arteries via transradial access.Meanwhile,the results of puncture,operation,duration of operation,intraoperative bleeding,postoperative complications,postoperative bed time and average hospital stay were observed,recorded and analyzed. Results The success rates of radial puncture and stenting operation were both 100%.The duration of operation was ≤30 min in 73.8% （38/52）,and the intraoperative bleeding volume,≤10 mL in 84.62% （44/52） of patients.Only two complications,bleeding of the puncture point and hematoma of the puncture site,appeared,the occurrence rate was 17.31% （9/52）.There were no difference of total occurrence rate of complication in gender and age （ P 〉0.05）.All patients needed not vessel suturing apparatus and moved out of bed immediately after operation.The average hospital stay was not increased. Conclusion Transradial stenting through the radial artery of the radial artery is clinically safe,reliable,and effective,and can be used as an alternative path for the transfemoral route.