经桡动脉途径行冠状动脉支架植入的研究

Implantation of the Coronary Artery Stents via the Radial Artery

目的 :探讨经桡动脉途径行冠状动脉支架植入治疗的可行性和安全性。方法 :选择我院 2 0 0 1年 12月到2 0 0 2年 10月住院、Allen’s试验阳性病人 3 0例 ,使用 6F桡动脉鞘行PTCA、支架植入。结果 :3 0例中发现病变 41处 ,对其中 3 4处进行了治疗 ,单纯PTCA4处 ,3 0处病变植入支架 3 5枚。经统计学处理 ,提示术前狭窄 87.4%± 7.9% ,术后无残余狭窄。平均桡动脉穿刺时间为 2 .8± 1.6分钟 ,一次桡动脉穿刺成功率 90 % ,术前和术后 2 4小时Allen’s试验时间无显著性差异 ,并发症少。结论 :本研究提示 ,经桡动脉途径植入冠状动脉支架安全可行、手术成功率高、血管并发症少、无需限制体位 ,可作为冠状动脉支架植入术的首选血管途径。

Objective: We aimed to get experiences of implantation of coronary artery stents via the radial artery and evaluate its feasibility and safety. Methods: 30 Allen's positive cases were treated, who were admitted during the period of December, 2001 to October, 2002. PTCA stents were implanted and 6F radial artery sheath system was used. Results: Among the 30 successful cases, 41 lesions were found, 34 of which were treated. Single PTCA were four. 35 stents were implanted in 30 vessel lesions. The statistics showed that vessel stenosis before the implantation was 87.4% + 7.9% and the residual stenosis after the implantation was not found. The average time of radial artery puncture was 2.8+1.6 minutes. The successful rate of the radial artery puncture in the first time was 90%. There were no remarkable differences in Allen's test time between the 24 hours before and after the implantation and its complications were rare. Conclusion: The results showed that the method was a safe and feasible approach with advantages of high successful implantation rate, few vessel complications and unnecessary postural limitation, and it might be the main choose in the implantation of coronary stents.