左桡动脉远端入路冠状动脉介入诊疗术的安全性和可靠性  

Percutaneous coronary intervention via left radial artery distal end access:evaluation of its safety and reliability

作　　者：魏显敬[1] 辛丽娜 解泽宙[1] 贾圣英[1] 徐思维 谢莲娜[1] WEI Xianjing;XIN Lina;XIE Zezhou;JIA Shengying;XU Siwei;XIE Lianna(Division IV Department of Circulation,Affliated Zhongshan Hospital of Dalian University,Dalian,Liaoning Province 116001,China)

机构地区：[1]大连大学附属中山医院循环四科,辽宁116001

出　　处：《介入放射学杂志》2022年第11期1069-1072,共4页Journal of Interventional Radiology

摘　　要：目的评估经左桡动脉远端穿刺行冠状动脉介入诊疗术的安全性和可靠性。方法选取2019年1月至2020年1月于大连大学附属中山医院接受冠状动脉造影和经皮冠状动脉介入治疗(PCI)的550例患者为研究对象,其中260例行右桡动脉穿刺,290例行左桡动脉远端穿刺,穿刺成功者分别入组A组、B组。观察两组介入穿刺置管时X线曝光时间、造影使用导管数、完成靶血管重建数、PCI复杂程度以及术后前臂出血、桡动脉并发症等。结果248例(95.4%)患者顺利完成右桡动脉穿刺冠脉诊疗术(A组),277例(95.5%)顺利完成经左桡动脉远端冠脉诊疗术(B组),差异无统计学意义(P>0.05)。两组X线曝光时间、造影使用导管数、完成靶血管重建数、PCI复杂程度差异无统计学意义(均P>0.05)。但B组围术期前臂出血、桡动脉闭塞发生率远小于A组(P<0.01,P=0.036)。结论经左桡动脉远端途径行冠状动脉诊疗术安全可靠,提高了术者和患者舒适性。Objective To evaluate the feasibility and reliability of catheterization via left radial artery distal end access in performing percutaneous coronary intervention(PCI).Methods A total of 550 patients,who received coronary angiography and PCI at the Affiliated Zhongshan Hospital of Dalian University of China between January 2019 and January 2020,were enrolled in this study.Of the 550 patients,right radial artery puncture was adopted in 260 and left radial artery puncture was employed in 290.The patients having a successful puncture were assigned in group A and group B,respectively.The X-ray exposure time during interventional puncture catheterization,the number of catheters used for coronary angiography,the number of successful target vessel recanalization,the complexity degree of PCI manipulation,the postoperative forearm bleeding,radial artery complications,etc.were recorded.Results Successful right radial artery puncture and PCI was accomplished in 248(95.4%)patients(group A),and successful left radial artery puncture and PCI was accomplished in 277(95.5%)patients(group B),the difference between the two groups was not statistically significant(P>0.05).No statistically significant differences in the X-ray exposure time during interventional puncture catheterization,the number of catheters used for coronary angiography,the number of successful target vessel recanalization and the complexity degree of PCI manipulation existed between the two groups(all P>0.05).The incidences of postoperative forearm bleeding and radial artery complications in group B were remarkably lower than those in group A(P<0.01 and P=0.036,respectively).Conclusion In performing coronary angiography and PCI,the catheterization via left radial artery distal end access is clinically safe and reliable,which can improve the comfort degree of both the operator and the patient.(J Intervent Radiol,2022,31:1069-1072)

关 键 词：冠状动脉造影 桡动脉闭塞 桡动脉远端入路 经皮冠状动脉介入治疗 

分 类 号：R543[医药卫生—心血管疾病]