高位桡动脉对经桡动脉途径冠状动脉介入治疗的影响  

Anatomical characteristics of high origin radial artery and its effect on transradial percutaneous coronary intervention

作　　者：靳志涛 李彦平 杨军珂 张铮 丁力平 高国杰 胡桃红 

机构地区：[1]第二炮兵总医院心血管内科,北京市100088 [2]解放军62402部队门诊部

出　　处：《中国心血管病研究》2015年第6期522-526,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨高位桡动脉解剖学变异对经桡动脉途径冠状动脉介入治疗的影响.方法 选取17例右侧高位桡动脉解剖学变异患者及与之匹配的60例桡动脉解剖学正常的患者,观察两组桡动脉影像学特征,并记录两组患者手术成功率、并发症发生情况.结果 两组患者基线资料均衡.17例高位桡动脉中,桡动脉起源于腋动脉6例（35.29％）,起源于肱动脉11例（64.71％）.高位桡动脉组患者右侧桡动脉平均直径为（2.62±0.60）mm,低于对照组平均直径（3.07±0.35）mm,两组差异具有统计学意义（P=0.008）.高位桡动脉组手术成功率为70.6％（12/17）,对照组手术成功率为98.3％（59/60）,差异具有统计学意义（P=0.002）.高位桡动脉组术后发生2例（11.76％）前臂血肿,1例（5.88％）上臂血肿;对照组出现1例（1.67％）前臂血肿.结论 对于存在高位桡动脉的患者,应该提高警惕,轻柔操作;而直径较为细小的高位桡动脉则应该视为经桡动脉途径冠状动脉介入治疗的禁忌,尽量避免采用.Objective This study aimed to investigate anatomical characteristics of high origin radial artery, and to explore its effect on transradial percutaneous coronary intervention. Methods 17 patients with high origin radial artery and 60 patients with nomal radial artery were enrolled to assess radiological features of radial artery, success rate and complications. Results Baseline characteristics of the two groups were well-balanced. In high origin radial artery group, the radial artery originated from the axillary artery in 6 cases （35.29%）, the brachial artery in 11 cases （64.71%）. The average diameter of the radial artery was （2.62±0.60）mm of high origin radial artery group, which was statistically lower than that of control group（3.07±0.35 ）mm（P=0.008）. Patients in high origin radial artery group was associated with a significantly lower rate of procedural success （70.6%） versus 98.3% in control group （P=0.002）. Postoperative complications in high origin radial artery group were happened as follows：forearm haematoma in 2 patients, upper arm haematoma in 1 patient. Forearm haematoma occurred in 1 patient in control group. Conclusion This study highlights the need for vigilance during transradial percutaneous coronary intervention, especially in patients with high origin radial artery. Mini-diameter high origin radial artery should be a contraindieation for transradial approach.

关 键 词：桡动脉解剖学异常 高位桡动脉 桡动脉造影 经桡动脉途径 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]