经桡动脉冠状动脉造影患者早期桡动脉闭塞相关危险因素分析

Risk factors of early radial artery occlusion in patients undergoing transradial coronary angiography

目的:经桡动脉入路冠状动脉操作目前已在世界范围内广泛应用。但是桡动脉闭塞结构性的并发症为这个优秀的通路蒙上了灰尘,因此探究桡动脉闭塞的危险因素从而有效的预防桡动脉闭塞是非常重要的。方法:连续入选我院行经桡动脉冠状动脉造影患者2368例,对其进行术前及术后桡动脉超声数据的采集,根据是否闭塞分为闭塞组(145例)和非闭塞组(2223例),根据术后桡动脉闭塞与否将患者分为闭塞组与非闭塞组,多个模型对总体人群进行Logistic多因素分析。ROC曲线分析模型的预测价值。结果:桡动脉总体闭塞率为6.1%(145/2368)。单因素分析显示闭塞组具有更小的管腔内经,更少的肝素用量及更长时间的压迫止血时间等。多因素模型显示TC、LDL-C、桡动脉内径、穿刺次数及肝素用量是桡动脉闭塞的预测因素,并具有良好的预测价值。结论:径桡动脉冠状动脉造影术后桡动脉闭塞率较高,较大的管腔内径及更高剂量的肝素可能会预防桡动脉的闭塞。

Objective:Coronary artery surgery via radial approach is widely used worldwide.However,the structural complication of radial artery occlusion casts dust on this excellent access,so it is important to explore the risk factors for radial artery occlusion in order to effectively prevent it.Methods:A total of 2368 patients underwent transradial coronary angiography in our hospital were successively enrolled.Ultrasonography was performed on the radial artery after surgery,and the patients were divided into the occlusion group(145 cases)and the non-occlusion group(2223 cases)according to whether occlusion was present.The two groups were statistically analyzed.Results:The overall radial artery occlusion rate was 6.1%(145/2368).Univariate analysis showed that the occlusion group had smaller intraluminal meridians,less heparin dosage,and longer compression and hemostasis time.Multivariate model showed that total cholesterol,low density lipoprotein cholesterol,radial artery diameter,number of puncture and amount of heparin were the predictors of radial artery occlusion,and had good predictive value.Conclusions:Radial artery occlusion rate is high after coronary angiography.Larger lumen diameter and higher dose of heparin may prevent radial artery occlusion.