A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.

Transradial Versus Transfemoral Approach for Percutaneous Coronary Intervention in Elderly Patients in China： A Retrospective Analysis

在老病人比较在 transradial 干预( TRI )和 transfemoral 干预( TFI )之间的医院费用和临床的结果的目的在我们识别了的 65 years.Methods 上使在 Fuwai 医院里经历了经皮的冠的干预(一种总线标准)的在 65 年变老的 1229 个病人变老，中国北京，在1月1日和2010年12月31日之间。全部的医院费用和在里面医院结果在 TRI 和 TFI 之间被比较。一个反的概率 weighting (IPW ) 模型被介绍控制经历了 TRI 的潜在的 biases.Results 病人更年轻，不太经常女性、更可能为单个容器的损害收到一种总线标准、不太可能为 ostial 损害经历过程。TRI 与一 CNY7495 节省花费被联系(95%CI：CNY4419-10 420 ) 。如此的差别被更低的一种总线标准相关的费用主要驾驶。TRI 病人有停留的更短的长度(1.9 天， 95%CI：1.1-2.7 天) ，更短的 procedural 以后停留(0.7 天， 95%CI：0.3-1.1 天) ，并且更少主要不利心脏的事件(调整机会比率 = 0.47， 95%CI：0.31-0.73 ) 。在在 TRI 和 TFI 之间的一种总线标准以后的流血的发生没有统计意义(P > 0.05 ) 。在在病人的 TRI 的使用在 65 年变老的尖锐心肌的梗塞，急性冠的症候群，和稳定的 angina.Conclusion 的临床上相关的亚群一致的仍然是的如此的差别与显著地减少的医院费用和更多的有利临床的结果被联系。

Effectiveness and feasibility of transradial approaches for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective： To evaluate the efficacy and feasibility of the transradial approach for primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction（AMI）. Methods： 195 patients with acute myocardial infarction were randomly divided into two groups according to the different PCI operation pathways. 105 cases were assigned to the transfemoral artery group and 90 cases to the transradial artery group. We analyzed the data from the two groups, including the achievement ratio of paracentesis, cannulation time, the time from local anesthesia to the first time balloon inflation, the time of the total procedure, achievement ratio of PCI, incidence rate of vascular complications, total duration of hospitalization, and the six-month follow-up results in both groups. Results： Our results showed that the achier ement ratio of arteriopuncture, cannulafion time and the time from local anesthesia to the first time balloon inflation in the transradial and transfemoral groups were 98.9% vs. 100%, 3.15 ± 1.56min vs. 2.86 ± 0.97 min, and 18.56 ± 4.37 min vs. 17.75 ± 3.21 min, respectively. These differences between the two groups were not statistically significant. The total operating time was 29.75 ± 4.38 rain for the transradial group and 27.89 ± 3.95 min（P 〈 0.05） for the transfemoral group. The operation achievement ratio in the transradial group was 96.7%, and 96.2% in the transfemoral group. The incidence of puncture point complications was 2.2% in the transradial group and 11.4% in the transfemoral group, and this difference was significant. The duration of hospitalization was 10.56 ± 2.85 days for the transradial group and 13.78 ± 3.15 days（P 〈 0.05） for the transfemoral group. At the six-month follow-up, the rate of survival without cardiac event was 86.1% vs. 86.4% respectively in the transradial and transfemoral groups（P 〉 0.05）. Conclusion： The transradial approach was as effective as the transfemoral approach, and there were fewer puncture point complications as well as a shorter span of hospitalization in the transradial group. PCI via the transradial approach is safe, effective and feasible in patients with AMI.

Safety and efficacy of transradial coronary angiography and intervention in patients older than 80 years： from the Korean Transradial Intervention Prospective Registry

为冠的过程的 BackgroundRadial 动脉存取是一种安全、有益的技术。然而，当存取地点的一个更高的风险组与更年轻的病人相比联系了复杂并发症，老病人被考虑了。这研究被进行调查 transradial 的可行性和安全在从在 20 个中心的朝鲜 Transradial 干预未来的登记的 6132 个病人的 elderly.MethodsA 总数的冠的 angiography 或干预被分析。病人们被划分成非老的组(n = 5667 ) 并且老(80 年) 组织(n = 465 ) 。用倾向分数匹配，老组(n = 465 ) 与相比一对一匹配非老的组(n = 465 ).ResultsAfter 倾向 20 匹配的、吝啬的年龄是 64.3 汵琠敲瑡敭瑮漠 ? 湩牴捡牡楤捡愠物攠扭汯獩 ? 獵湩 ? 湩牴捡牡楤捡挠瑡敨整 ?

Comparison of transradial and transfemoral percutaneous coronary intervention in women:a propensity score matching-based analysis

Objective We conducted the present study in order to compare safety and efficacy of transradial intervention(TRI)and transfemoral intervention(TFI)in women undergoing percutaneous coronary intervention(PCI)in a large heart center in China.Methods The study population consisted of a consecutive cohort of 5,067 women undergoing PCI in Fuwai Hospital,Beijing,China between 2006 and 2011(TRI:n=4,105,TFI:n=962).

The Transradial Approach for Cardiac Catheterization and Percutaneous Coronary Intervention:A Review

Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease.Although the transfemoral approach has been the traditionally dominant method,there has been an increased utilization of the transradial approach.Multiple observational studies and randomized clinical trials have shown fewer bleeding complications,reduced morbidity and mortality,improved quality of life,and better economic outcomes when the transradial approach is utilized when compared to the transfemoral approach.Despite its many benefits,utilization of this approach in certain countries including the United States has been less than optimal due to a lower adoption rates mostly driven by lack of training opportunities and decreased awareness of clinical benefits of the transradial approach.In this review,the history,observational trends,efficacy,and technical aspects of transradial cardiac catheterization and percutaneous coronary intervention are discussed.

Comparison of distal radial artery access and conventional transradial access for percutaneous coronary intervention

Background Distal radial artery access(DRA)has emerged as an alternative to conventional transradial access(TRA)for percutaneous coronary interventions(PCI).This study aims to compare the efficacy and safety of DRA versus TRA.Methods A total of 873 participants were enrolled,divided into the DRA group(n=236)and the TRA group(n=637).The primary endpoint was the success rate of access puncture.Secondary endpoints included procedural efficiency,patient comfort,and complication rates.Baseline characteristics,procedural data,and outcomes were analyzed and compared between the two groups.Results The success rates for access puncture showed no significant statistical difference between the DRA and TRA groups.However,the DRA group required more puncture attempts.DRA showed significant advantages,including shorter hemostasis times,reduced access puncture and postprocedural pain,and lower incidences of radial artery occlusion(2.1%vs.6.1%,P=0.043)and hematoma(1.7%vs.5.2%,P=0.037).Conclusions DRA is a viable alternative to TRA for performing PCI,offering comparable success rates and procedural efficiency with improved patient comfort and reduced complications.

Transradial approach for coronary procedures in the elderly population

Transradial 心脏的 catheterisation 被报导了与有在一样的天执行过程和分泌物的更容易、更安全的 procedural 以后 haemostasis，更好耐心的舒适，更早的移动和可能性的另外的途径相比更有益。仅仅有有限数据，在老人口检验 transradial 存取。在这评论，我们看了可得到的文学给与 transfemoral 和其它相比的 transradial 途径怎么在老人口来临的卓见。老人口在脉管的存取地点流血的更高的风险， transradial 途径显示出相等的功效到 transfemoral 途径。然而， transradial 途径显著地减少脉管的复杂并发症，医院停留，动员时间和不利心脏的事件。因此， transradial 途径应该在老人口被看作比较喜欢的脉管的存取地点。

The Current State of Transradial Access:A Perspective on Transradial Outcomes,Learning Curves,and Same-Day Discharge

The adoption of transradial access in the United States and internationally has been growing over the past few years.In the population of patients presenting with acute coronary syndromes,particularly ST-elevation myocardial infarction,transradial access has the benefit of fewer vascular and bleeding complications and lower mortality rates over transfemoral access.We will examine the current evidence supporting transradial access for several patient populations,including those patients presenting with acute coronary syndromes.We will review the literature regarding the learning curve for transradial access with new operators,as well as experienced transfemoral operators new to transradial access.Finally,we will investigate the role of transradial access in same-day discharge for stable patients undergoing percutaneous coronary intervention.

Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction

Background Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention （PCI） in elderly patients with acute myocardial infarction （AMI）. Methods A total of 103 consecutive elderly patients Cage 〉65 years） who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach （transradial intervention, TRI group）, and 46 underwent primary PCI via the transfemoral approach （transfemoral intervention, TFI group）. The success rate of puncture, puncture time, cannulation time, repeffusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump （IABP）, and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events （MACE） in the two groups in one month were observed. Results The success rates of puncture （98.2% vs 100.0%） and PCI （96.5% vs 95.7%） for the patients in the TRI and TFI groups were not statistically significant （P〉0.05）. The puncture time （（2.4±1.1） vs （2.0±0.9） minutes）, cannulation time （（2.7±0.5） vs （2.6±0.5） minutes）, reperfusion time （（16.2±4.5） vs （15.4±3.6） minutes）, total time of the procedure （（44.1±6.8） vs （41.2±5.7） minutes）, use rates of temporary pacemaker （1.8% vs 2.2%） and IABP （0 vs 2.2%） in the two groups were not statistically significant （P〉0.05）, but the hospital stay of the TFI group was longer than that of the TRI group （（10.1±4.6） vs （7.2±2..6） days, P〈0.01）. A radial occlusion was observed in the TRI group, but no ischemic syndrome in hand. In the TFI group, 4 patients had hematosis, 1 had pseudoaneurysm, and 1 had major bleeding. Statistical significance in vascular access site complications was seen in the two groups （1.8 % vs 13.1%, P〈0.05）. Three patients died in the two groups respectively in one month, and there was no statistical significance in MACE in the two groups （5.3% vs 6.5%, P〉0.05）. Conclusion The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.

Improved outcomes from transradial over transfemoral access in primary percutaneous coronary intervention for patients with acute ST-segment elevation myocardial infarction and upstream use of tirofiban

Background Transradial access has been increasingly used during primary percutaneous coronary intervention （PCI） for patients with acute ST-segment elevation myocardial infarction （STEMI） in last decade. Clinical benefits of upstream use of tirfiban therapy in STEMI patients treated by primary PCI have been reported. We investigated the merits of transradial vs. transfemoral access in primary PCI for STEMI patients with upstream use of tirofiban. Methods Patients with STEMI treated with tirofiban between December 2006 and October 2012 then by primary PCI were compared between transradial （n=298） and transfemoral （n=314） access. Baseline demographics, angiographic and PCI features and primary endpoint of major adverse cardiac events （MACE） at 30-day clinical follow-up were recorded. Results Baseline and procedural characteristics were comparable between the two groups, apart from more patients in transradial group had hypertension and were treated by thrombus aspiration during primary PCI. Significantly fewer MACE occurred in the transradial group （5.4%） compared with the transfemoral group （9.9%） at 30-day clinical follow-up. Major bleeding events at 30-day clinical follow-up were 0 in transradial group and in 2.9% of transfemoral group. Multivariate analysis confirmed transradial approach as an independent negative predictor of 30-day MACE （HR 0.68; 95% CI 0.35-0.91; P=0.03）. Conclusions Using transradial approach in primary PCI for acute STEMI infarction patients treated with tirofiban was clearly beneficial in reducing bleeding complications and improving 30-day clinical outcomes.

Comparison of immediate and followup results between transradial and transfemoral approach for percutaneous coronary intervention in true bifurcational lesions

Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention （PCI） in bifurcations has not been done. This study evaluated feasibility of transradial PCI （TRI） and compared the immediate and followup results with transfemoral PCI （TFI） in bifurcations. Methods One hundred and thirty-four consecutive patients with bifurcations were treated with PCI in our hospital from April 2004 to October 2005. Of these, there were 60 patients （88 lesions） in TRI group and 74 patients （101 lesions） in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification. Results TRI group had smaller stent diameter （（3.06±0.37） mm vs （3.18±0.35） mm, P=0.023） and postprocedural in-stent minimum lumen diameter （（2.62±0.37） mm vs （2.74±0.41） mm, P=0.029） than TFI, but there were not significant differences in in-stent subacute thrombosis rate （0% vs 1.0%, P=0.349）, target lesion revascularization （TLR） （0% vs 1.0%, P=0.349） following procedure and thrombosis （2.3% vs 1.0%, P=0.482）, in-stent restenosis （12.5% vs 10.9%, P=0.731）, in-segment restenosis （17.0% vs 14.9%, P=0.681）, TLR （10.2% vs 13.9%, P=0.446） and TLR-free cumulative survival rate （89.8% vs 86.1%, P=0.787） at seven months followup. No death was reported in the two groups. Conclusion Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.

Safety and feasibility of emergent percutaneous coronary intervention with the transradial access in patients with acute myocardial infarction

The use of intense anticoagulation and antiplatelet therapy in acute myocardial infarction （AMI）potentially increases the risk of bleeding complications during percutaneous coronary intervention （PCI） via the transfemoral approach. Recently, the transradial access has been increasingly employed as an alternative means for diagnostic and interventional procedures. Low incidence of vascular access site bleeding complications suggests the transradial approach as a safe alternative to the femoral technique in AMI, particularly under an aggressive anticoagulation/antiplatelet regimen.Nevertheless, the safety and feasibility of employing the transradial approach for primary PCI in AMI has not been thoroughly investigated so far.

前臂压迫止血器与传统疗法治疗TRI术后前臂血肿的比较和经验总结

目的 初步探讨手工压迫法、绷带压迫法、前臂压迫止血器法和前臂压迫止血器联合脱水治疗法在治疗冠状动脉介入诊疗（TRI）术后患者出现前臂张力性血肿时的效果,为临床出现前臂血肿后进行科学处理提供依据.方法 回顾分析我科2014年4月至2016年2月TRI术后出现的334例前臂张力性血肿患者资料,按照处理方式不同,分为手工压迫组、绷带压迫组、前臂压迫止血器组和前臂压迫止血器联合脱水治疗组,对四组病例进行统计学分析,比较不同处理方法的效果差异.结果 334例前臂血肿患者中,手工压迫组（79例）与绷带压迫组（81例）相比较,肿胀消退时间、周围皮肤温度增加出现的时间、手指末端血供和功能改善为良好的出现时间及肿胀压迫后3h前臂臂围等四个主要指标比较未见统计学差异（P＞0.05）.压迫止血器组（88例）与手工压迫组和绷带压迫组之间分别比较,上述四个主要观察指标比较未见统计学差异（P＞0.05）;压迫止血器联合脱水处理组（86例）与手工压迫组和绷带压迫组之间四个主要观察指标分别比较差异有统计学意义（P＜0.05）.结论 TRI术后前臂张力性血肿的处理,人工压迫与绷带压迫效果相当,前臂压迫器能起到和手工压迫和绷带压迫一样的效果,在前臂压迫器压迫的基础上,同时积极进行脱水等综合处理,效果更加显著.

Nursing observation of transradial coronary intervention combined with tirofiban hydrochloride for acute coronary syndrome in elderly patients

Background As the most effective approach in treatment of revascularization in coronary perfusion for acute coronary syndromes（ACSs）, percutaneous coronary intervention（PCI） can also increase the risk of detachment of thrombus and embolism of distal microcirculation. Tirofiban hydrochloride is a reversible antagonist of platelet glycoprotein Ⅱb / Ⅲa receptor, which can inhibit platelet aggregation quickly. However,it may also increase the risk of bleeding when in combination with other anti-thrombus drugs. It is important in medication observation for charge nurse when using Ⅱ b / Ⅲ a receptor inhibitor. Methods For 116 elderly patients with ACS who had transradial coronary interventional therapy combined with tirofiban hydrochloride,we conducted medication care, nursing observation of hemorrhage, nursing of puncture of upper limb,postoperative adverse cardiovascular events, observation of myocardial perfusion, blood flow and health education. Results A total of 10 patients had mild bleeding, no serious bleeding, and 2 with major adverse cardiac event（MACE）. Conclusions Tirofiban hydrochloride after PCI can significantly reduce cardiovascular events in acute coronary syndromes, but there is an increased risk of bleeding. It showed that strengthen inspection, closely observe condition and detecting bleeding in time after PCI can significantly reduce postoperative complications for charge nurses.

经桡动脉入路冠脉介入治疗患者术肢并发症护理研究进展

经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)已成为治疗冠心病的主要手段之一。经桡动脉入路作为PCI的主要血管入路,由于其便捷性和较低的并发症风险而被广泛采用。然而,经桡动脉入路PCI仍存在血管损伤、出血等并发症。因此,针对经桡动脉入路PCI并发症的管理非常重要。本文对经桡动脉入路PCI并发症及相关危险因素的评估及护理要点进行阐述,期望增加临床医护对桡动脉入路并发症的认识,为PCI患者争取更大获益。

Effectiveness and Feasibility of Transradial Approach for Primary Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

Objectives To evaluate the effectiveness and feasibility of transradial approach for primary, emergency percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods One hundred and ninety five patients with AMI undergone primary PCI were randomized into two groups using different catheter insertion pathways ： 105 cases by transfemoral approach and 90 cases by transradial approach. We compared data of different operating approaches in terms of success rate of access, cannulation time, the time from local anesthesia to the first balloon inflation, the total procedure time, success rate of PCI, access site complications, total duration of hospitalization, and the clinical outcomes at six-month follow-up. Results The success rate of artery puncture, cannulation time, and the time from local anesthesia to the first balloon inflation in the transradial and transfemoral groups were 98.9 % vs 100 % （P 〉0. 05）, 3.15 ± 1.56 minutes vs 2. 86 ± 0.97 minutes （P 〉0. 05）, and 18.56 ± 4. 37 minutes vs 17.75± 3.21 minutes （P 〉 0. 05 ）, respectively. Although the total procedure time was significantly shorter in the transfemoral group （27.89 ± 3.95 minutes） than in the transradial group （29.75 ±4. 38 minutes） （P 〈0. 05）, the overall PCI success rate was similar between the two groups （96.2 % vs 96. 7 % ）. Use of the transradial approach was associated with fewer access site complications （ 2. 2 % vs 11.4 %, P 〈 0. 05 ） and a shorter length of hospital stay （ 10. 6 days vs 13.8 days, P 〈 0. 05 ）. At six-month follow-up, the cumulative cardiac event-free survival rate was 86. 1% and 86. 4% （P 〉 0. 05 ）, respectively, in the transradial and transfemoral groups. Conclusions Transradial approach achieved similar effectiveness as transfemoral approach in emergency PCI. However, the use of the transradial approach decreased access complications and hospital stay. Primary PCI via transradial approach is safe, effective, and feasible in patients with AMI.

早期下床活动对经桡动脉行冠状动脉介入术患者应用效果的Meta分析

目的系统评价经桡动脉行冠状动脉介入术患者术后早期下床活动的效果。方法检索1993年1月1日至2023年12月31日发表在Cochrane Library、PubMed、Web of Science、Embase、中国知网、中国生物医学文献数据库、维普资讯网、万方数据库和国内外临床试验注册中心有关经桡动脉行冠状动脉介入术后早期下床活动的试验性研究,对纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳入12项研究,Meta分析结果显示,与常规康复相比,经桡动脉行冠状动脉介入术后早期下床活动有利于改善患者左室射血分数[MD=4.35,95%CI(1.96,6.74),P<0.01];能提高患者生活质量[SMD=2.56,95%CI(1.37,3.75),P<0.01];增强患者日常生活能力[MD=3.78,95%CI(1.87,5.69),P<0.01];降低心绞痛[OR=0.35,95%CI(0.16,0.79),P=0.01]、心律失常[OR=0.33,95%CI(0.15,0.70),P<0.01]和心力衰竭[OR=0.35,95%CI(0.13,0.91),P=0.03]发生率;对改善冠状动脉再狭窄[OR=0.28,95%CI(0.07,1.16),P=0.08],左室舒张末内径[MD=-1.53,95%CI(-4.58,1.53),P=0.33]和6分钟步行距离[MD=32.87,95%CI(-2.03,67.77),P=0.06]效果不显著。结论早期下床活动可以明显改善经桡动脉行冠状动脉介入术后患者的心功能,提高其生活质量和日常生活能力,减少并发症,促进患者的康复。

便携式电子感应硬胶海绵垫在TRI术后的应用

经桡动脉冠状动脉介入治疗（TRI）技术目前已成为经皮冠状动脉介入治疗（PCI）的主要路径,由于术后穿刺处仍需加压压迫并制动6h,这使得部分患者仍感疼痛、肿胀或更换体位不便等不适。目前,临床使用各种材质制成的抬高垫来缓解术后的诸多不适,但还是存在一些弊端。鉴此,我们设计了便携式硬胶海绵垫电子感应装置应用于TRI术后,并取得了良好效果,现介绍如下。1材料与制作该装置为硬胶海绵材质构成的不等边三角形,最小的锐角坡度为40°,长度为15cm;两头各有一条绑带,上面有刺毛搭扣;绑带顶端设有湿度传感器。见图1。

经远端桡动脉路径在冠心病诊疗中的研究进展及展望

近年来冠心病的发病率呈逐年上升趋势,经皮冠状动脉介入治疗是冠心病的有效治疗方法之一,而桡动脉是其传统的血管路径。舒适化医疗医学时代,经远端桡动脉路径(dTRA)是一种用于冠状动脉造影和经皮冠状动脉介入治疗的新手术路径,其具有局部并发症少,患者舒适度高等优点,正在逐渐替代传统桡动脉路径(TRA)。然而,作为近两年新兴的技术,dTRA也存在一些缺点,如血管扭曲、直径小等,可能导致穿刺失败、血管痉挛、导丝送入困难等不良事件。本文就dTRA行冠状动脉介入诊疗的应用价值及进展作一综述,以促进其在临床诊疗中推广,进而使更多患者获益。