国产7F薄壁鞘管经鼻烟壶区远端桡动脉入路经皮冠状动脉介入治疗的疗效和安全性分析  

Efficacy and Safety of the Distal Transradial Approach in Percutaneous Coronary Intervention With the 7 French Glidesheath Slender

作　　者：徐娜[1] 徐淑清[2] 刘海明 王攀 唐杨 张海峰 石万克 宋莹[1] 崔成 王欢欢[1] 田涛[1] 刘小宁[1] 张茵[1] 宋雷[1] 高展[1] 刘海波[1] 陈珏[1] 徐波[1] 吴永健[1] 杨伟宪[1] 袁晋青[1] 高立建[1] XU Na;XU Shuqing;LIU Haiming;WANG Pan;TANG Yang;ZHANG Haifeng;SHI Wanke;SONG Ying;CUI Cheng;WANG Huanhuan;TIAN Tao;LIU Xiaoning;ZHANG Yin;SONG Lei;GAO Zhan;LIU Haibo;CHEN Jue;XU Bo;WU Yongjian;YANG Weixian;YUAN Jinqing;GAO Lijian(Department of Cardiology,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科,北京市100037 [2]吉林省长春市人民医院心内科 [3]吉林省德惠市人民医院心内科 [4]新疆生产建设兵团第五师医院心内科 [5]新疆生产建设兵团第七师医院心内科 [6]河南省平煤神马医疗集团总医院心内科 [7]广西都安县人民医院心内科

出　　处：《中国循环杂志》2022年第11期1086-1090,共5页Chinese Circulation Journal

摘　　要：目的:分析应用国产7F薄壁鞘管经鼻烟壶区远端桡动脉入路(dTRA)经皮冠状动脉介入治疗(PCI)的疗效和安全性。方法:连续纳入2021年6月至2022年1月在中国医学科学院阜外医院使用国产7 F薄壁鞘管经鼻烟壶区dTRA行PCI的患者共63例。分析手术成功率、即刻入路相关并发症和24 h桡动脉闭塞的发生情况。结果:63例患者中,1例穿刺失败,更改为右桡动脉穿刺,远端桡动脉穿刺成功率为98.4%;4例患者因闭塞血管病变严重未能开通,PCI手术成功率为93.7%,平均PCI手术时间为(80.1±43.5)min。3例(4.8%)患者成功完成左侧dTRA,47例(74.6%)患者成功完成右侧dTRA,12例(19.0%)患者成功完成双侧dTRA(均为慢性完全闭塞病变)。穿刺时间和X线曝光时间(透视时间)分别为(3.0±1.7)min和(38.8±18.9)min。术后4例(6.3%)发生血管并发症,包括1例穿刺部位少量出血,无皮下血肿,1例桡动脉痉挛,2例术后手臂疼痛/肿胀,所有患者均未发生24 h桡动脉闭塞。结论:使用国产7F薄壁鞘管经鼻烟壶区dTRA治疗复杂冠状动脉病变具有较高的成功率,行PCI安全、有效,术后即刻入路血管并发症发生率低,桡动脉闭塞发生率低。Objectives:To analyze the efficacy and safety of the distal radial artery approach(dTRA)for percutaneous coronary intervention(PCI)with the 7 French(7F)Glidesheath slender.Methods:63 consecutive patients who underwent PCI via dTRA with 7F Glidesheath slender at Fuwai Hospital from June 2021 to January 2022 were enrolled in this analysis.The surgical success rate,vascular complications and radial artery occlusion(RAO)at 24 h were analyzed.Results:Among the 63 patients,dTRA puncture failed in 1 case and the right brachial artery puncture was performed instead;the success rate of distal radial artery puncture was 98.4%.PCI failed in 4 patients due to severe occlusive coronary artery disease,and the success rate of PCI was 93.7%(59/63).The mean PCI procedure time was(80.1±43.5)minutes.Three(4.8%)cases successfully completed the left dTRA access,47(74.6%)cases completed the right dTRA access and bilateral dTRA access was performed for chronic total occlusion lesions in 12 cases(19.0%).The puncture time and fluoroscopy time were(3.0±1.7)minutes and(38.8±18.9)minutes,respectively.Postoperative complications occurred in 4 cases(6.3%)at the puncture site,including 1 case of minor bleeding at the puncture site(no subcutaneous hematoma occurred),1 case of radial artery spasm,and 2 cases of postoperative arm pain and swelling.Distal radial artery occlusion was not observed in this patient cohort.Conclusions:Using 7F guiding catheter through dTRA puncture in patients with complex PCI is safe and associated with high success rate.The incidence of postoperative vascular complications and radial artery occlusion is low in this patient cohort.

关 键 词：7F薄壁鞘管 远端桡动脉 经皮冠状动脉介入治疗 并发症 

分 类 号：R54[医药卫生—心血管疾病]