Fukuda Naoto, Iwahara Shin-Ichiro, Harada Atsushi, Yokoyama Shinya, Akutsu Kouichi, Takano Masamichi, Kobayashi Akiyoshi, Kurokawa Shingo, Izumi Tohru
Department of Internal Medicine and Cardiology, Kitasato University School of Medicine, Kanagawa 228-8555, Japan.
Jpn Heart J. 2004 Sep;45(5):723-31. doi: 10.1536/jhj.45.723.
We examined vasospasms of the radial artery after a transradial approach was used for coronary angiography or angioplasty. In forty-eight patients (39 males and 9 females), arteriography of the radial artery was initially performed just after the transradial approach was used for coronary angiography and/or angioplasty. Then, five months later, a second arteriography of the radial artery was obtained after a transbrachial approach was used for coronary angiography. First and second arteriographies were compared to evaluate vaso-spasms of the radial artery. In the present study, more than 75% stenosis in the radial artery, 25-75% stenosis, and less than 25% stenosis were tentatively defined as severe spasms, moderate spasms, and mild spasms, respectively. In arteriographic studies on the radial artery, twenty-four patients (50%) had severe radial artery spasms, eleven patients (23%) had moderate spasms, and thirteen patients (27%) had mild spasms. The diameters of both the proximal and distal radial arteries in the severe spasm group were significantly smaller than those in the mild and moderate spasm groups (proximal site: severe group 2.39 +/- 0.70 mm versus mild group 2.98 +/- 0.46 mm, P < 0.05, and moderate group 2.96 +/- 0.77 mm, P < 0.05, distal site: severe group 2.26 +/- 0.60 mm versus mild group 2.73 +/- 0.47 mm, P < 0.05, and moderate group 2.86 +/- 0.71 mm, P < 0.05). We concluded that vasospasms of the radial artery occurred in most patients after the transradial approach. Furthermore, severe radial spasms were strongly correlated with the size of the diameter of the artery.
我们对采用经桡动脉途径进行冠状动脉造影或血管成形术后的桡动脉痉挛情况进行了研究。在48例患者(39例男性和9例女性)中,在经桡动脉途径用于冠状动脉造影和/或血管成形术后即刻,首先对桡动脉进行血管造影。然后,5个月后,在采用经肱动脉途径进行冠状动脉造影后再次对桡动脉进行血管造影。比较首次和第二次血管造影结果,以评估桡动脉痉挛情况。在本研究中,桡动脉狭窄超过75%、25% - 75%狭窄以及狭窄小于25%分别被暂定为严重痉挛、中度痉挛和轻度痉挛。在桡动脉造影研究中,24例患者(50%)出现严重桡动脉痉挛,11例患者(23%)出现中度痉挛,13例患者(27%)出现轻度痉挛。严重痉挛组桡动脉近端和远端的直径均显著小于轻度和中度痉挛组(近端部位:严重组2.39±0.70mm,轻度组2.98±0.46mm,P<0.05,中度组2.96±0.77mm,P<0.05;远端部位:严重组2.26±0.60mm,轻度组2.73±0.47mm,P<0.05,中度组2.86±0.71mm,P<0.05)。我们得出结论,经桡动脉途径后大多数患者会出现桡动脉痉挛。此外,严重桡动脉痉挛与动脉直径大小密切相关。