经桡动脉途径介入治疗老年患者冠状动脉分叉病变  

Transradial coronary intervention for the treatment of bifurcation lesions in elderly patients

作　　者：史冬梅[1] 曹政[1] 周玉杰[1] 姜明明[1] 郭敏[1] 成万钧[1] 

机构地区：[1]首都医科大学附属北京安贞医院十二病房,北京市100029

出　　处：《中国介入心脏病学杂志》2010年第1期5-8,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的通过对比桡动脉、股动脉途径PCI治疗老年患者冠状动脉分叉病变的成功率、手术即刻效果及患者的术后近中期预后情况,探讨经桡动脉(TRI)途径处理老年患者冠状动脉分叉病变的可行性和安全性。方法研究共入选135例接受PCI治疗的老年冠状动脉分叉病变患者,根据初始选择的介入途径分为TRI组(n=64)和经股动脉(TFI)组(n=71),对比两组患者接受PCI治疗的成功率、造影剂用量、手术时间、并发症的发生率及再狭窄的发生率。结果TRI组64例中63例成功使用经桡动脉动脉,1例由于桡动脉严重痉挛并入股动脉组。PCI成功率TRI组为98.4%,TFI组为100%。PCI术中,TRI组84.1%的患者选用的是6F导引导管,而TFI组76.4%患者选用的是7F导引导管。术后TRI组仅1例患者出现血管并发症,而TFI组患者中有5例患者出现了血管并发症。TRI组和TFI组患者在PCI术后9个月时严重心脏不良事件的发生率(14.3%比15.3%)、支架血栓事件(1/6比1/71)及随访期造影提示主、边支界定再狭窄率(10.9%比10.0%,17.4%比22.0%)差异无统计学意义。结论经桡动脉途径PCI治疗老年患者分叉病变具有良好的可行性和安全性,有利于降低血管并发症的发生率。Objective To investigate the feasibility and safety of transradial artery approach for percutaneous angioplasty in elderly patients with bifurcation lesions. Methods We reviewed 135 elderly patients with bifurcation lesions who had undergone PCI . Among them, 63 patients received the procedure by transradial approach and the other 72 patients by transfemoral approach. The success rate of the procedure, the procedural time, the amount of contrast media consumed and vascular complications between the two groups were compared. The end points were the incidence of MACE and stent thrombosis during 9 months of follow-up. Results Patients in transradial group were more likely to present with dyslipidemia than those in the transfemoral group. The procedural success rate was 98.2% in the transradial group. The 6 F guiding catheters were used in the majority of the patients in the transradial group （84.1%） while the 7 F guiding catheters were more used in the transradial group （76.4%） . Vascular complications were recorded in 1 patient from the transradial group and 5 patients from the transfemoral group. During the 9-month follow-up, stent thrombosis occurred in 1 patient in each group respectively and the incidenc of MACE was similar between the two groups （13.4% vs 11.9%, P0.05）. Conclusion Transradial intervention is as feasible and safe as transfemoral PCI in treatment of bifurcation lesions in elderly patients.

关 键 词：桡动脉 冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 老年人 

分 类 号：R543.3[医药卫生—心血管疾病]