球囊辅助通过技术在桡动脉通过失败时的应用分析

Application of balloon assisted track technique in the transradial approach intervention

目的比较在不同原因导致桡动脉通过困难时,采用球囊辅助通过(BAT)技术的有效性和安全性。方法回顾性分析2015年1月至2017年12月北京安贞医院563例因桡动脉通过困难而采用BAT技术辅助经桡动脉入径行经皮冠状动脉介入治疗(PCI)的患者。根据采用BAT技术的原因不同,分为桡动脉狭窄组382例、桡动脉损伤组98例及桡动脉迂曲组83例。观察近3年BAT应用范围及成功率的变化,并比较三组患者BAT技术的成功率及并发症发生率。结果 BAT技术应用具有逐年增加趋势,其成功率也逐年提高,2015年度、2016年度、2017年度分别67.2%、81.2%及95.3%,趋势卡方检验示,差异有统计学意义(P<0.01)。通过比较不同原因采用BAT技术的成功率发现,桡动脉狭窄组成功率最高(99.5%),其次为桡动脉损伤组(70.4%)及桡动脉迂曲组(50.6%),差异有统计学意义(P<0.001);三组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论 BAT技术的应用逐年增加,成功率逐年改善。但针对不同人群,其成功率有明显差异,故在临床应用时,需加强适应证的甄别。

Objective Compare the eff ectiveness and safety of Balloon Assisted Track (BAT) technique when the radial artery was diffi cult to pass through for diff erent reasons. Methods A retrospective analysis of 563 patients who underwent transradial approach (TRA) intervention with BAT technique in the past 3 years. According to the reasons for the application of BAT technique, those patients were divided into the radial artery stenosis group, the radial artery injury group and the radial artery distortion group. The changes in BAT application range and success rate were observed in the past 3 years, and the success rate and complication of BAT technique among the three groups were analyzed. Results The application of BAT technology had been increasing year by year. The BAT success rate in each year were 67.3%, 81.2% and 95.3%, respectively, and the diff erence was statistically signifi cant (P<0.01). By comparing the success rate of BAT technique for different reasons, the highest success rate was 99.5% in radial artery stenosis group;followed by 70.4% in the radial artery injury group and 50.6% in the radial artery distortion group. The diff erence between the three groups was signifi cant (P<0.001);There was no signifi cant diff erence in the incidence of complications between the 3 groups. Conclusions The application of BAT technique and the success rate has increased year by year. However, for diff erent populations, the success rate is signifi cantly diff erent, so the optimal indications need to be carefully screened.