经桡动脉入路冠状动脉造影及介入治疗的发展历程与展望

Radial access for coronary angiography and intervention:past,present and future

冠状动脉(冠脉)造影及介入治疗术是常用的冠脉疾病微创检查及治疗术。经桡动脉入路是目前国内外冠脉造影及介入治疗术最常用的手术入路。这一入路从诞生伊始,便逐步发展,随着循证医学证据的不断更新,目前作为手术的常规入路已被广泛认可。同时,有充分证据表明,经桡动脉入路可以胜任复杂、高危冠脉病变的介入治疗。经桡动脉入路冠脉造影及介入治疗在我国起步较晚,发展迅速,普及率极高。中国的冠脉介入治疗指南比欧洲、美国更早一步就推荐将经桡动脉入路作为手术入路的首选。虽然经桡动脉入路也存在一些客观限制,但随着器械的进步及介入医师技术水平的提高,经远桡动脉入路冠脉造影及介入治疗也在不断开展。此外,经桡动脉入路在外周动脉介入及神经介入领域的应用亦在探索之中。

Coronary angiography and intervention are commonly used minimally invasive examinations and operations for coronary artery diseases.The radial access is currently the most commonly used operational approach for coronary angiography and intervention both domestically and internationally.This access has gradually developed since its inception,and with the continuous updating of evidence,it has been widely recognized as a routine access.Meanwhile,sufficient evidence also suggests that the radial access can be competent for intervention of complex and high-risk coronary artery lesions.Transradial coronary angiography and intervention started relatively late and developed rapidly in China,with a high prevalence now.Chinese coronary intervention guideline recommended the radial access as the preferred operational access earlier than Europe and the United States.Although there are some objective limitations to the radial access,with the advancement of instruments and the improvement of interventional physicians’technique,coronary angiography and intervention through the distal radial artery are also constantly being carried out.In addition,the application of radial access in peripheral artery intervention and neural intervention is also being explored.