经桡动脉与经股动脉途径行真性分叉病变经皮冠状动脉介入治疗的即刻与随访结果比较

Comparison of immediate and followup results between transradial and transfemoral approach for percutaneous coronary intervention in true bifurcational lesions.

作者信息

Yang Yue-jin, Xu Bo, Chen Ji-lin, Kang Sheng, Qiao Shu-bin, Qin Xue-wen, Yao Min, Chen Jue, Wu Yong-jian, Liu Hai-bo, Yuan Jin-qing, You Shi-jie, Li Jian-jun, Dai Jun, Gao Run-lin

机构信息

Centre for Coronary Artery Disease, Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Chin Med J (Engl). 2007 Apr 5;120(7):539-44.

PMID:17442199

Abstract

BACKGROUND

A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention (PCI) in bifurcations has not been done. This study evaluated feasibility of transradial PCI (TRI) and compared the immediate and followup results with transfemoral PCI (TFI) in bifurcations.

METHODS

One hundred and thirty-four consecutive patients with bifurcations were treated with PCI in our hospital from April 2004 to October 2005. Of these, there were 60 patients (88 lesions) in TRI group and 74 patients (101 lesions) in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification.

RESULTS

TRI group had smaller stent diameter ((3.06 +/- 0.37) mm vs (3.18 +/- 0.35) mm, P = 0.023) and postprocedural in-stent minimum lumen diameter ((2.62 +/- 0.37) mm vs (2.74 +/- 0.41) mm, P = 0.029) than TFI, but there were not significant differences in in-stent subacute thrombosis rate (0% vs 1.0%, P = 0.349), target lesion revascularization (TLR) (0% vs 1.0%, P = 0.349) following procedure and thrombosis (2.3% vs 1.0%, P = 0.482), in-stent restenosis (12.5% vs 10.9%, P = 0.731), in-segment restenosis (17.0% vs 14.9%, P = 0.681), TLR (10.2% vs 13.9%, P = 0.446) and TLR-free cumulative survival rate (89.8% vs 86.1%, P = 0.787) at seven months followup. No death was reported in the two groups.

CONCLUSION

Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.

摘要

背景

尚未对经桡动脉和经股动脉途径在分叉病变经皮冠状动脉介入治疗（PCI）中的疗效和安全性进行比较。本研究评估了经桡动脉PCI（TRI）的可行性，并比较了其与经股动脉PCI（TFI）在分叉病变中的即刻和随访结果。

方法

2004年4月至2005年10月期间，我院连续134例分叉病变患者接受了PCI治疗。其中，TRI组60例患者（88处病变），TFI组74例患者（101处病变）。根据巴黎南部心血管研究所分类法对分叉病变类型进行分类。

结果

TRI组的支架直径（（3.06±0.37）mm对（3.18±0.35）mm，P = 0.023）和术后支架内最小管腔直径（（2.62±0.37）mm对（2.74±0.41）mm，P = 0.029）均小于TFI组，但两组在支架内亚急性血栓形成率（0%对1.0%，P = 0.349）、术后靶病变血运重建（TLR）（0%对1.0%，P = 0.349）以及血栓形成（2.3%对1.0%，P = 0.482）、支架内再狭窄（12.5%对10.9%，P = 0.731）、节段内再狭窄（17.0%对14.9%，P = 0.681）、7个月随访时的TLR（10.2%对13.9%，P = 0.446）和无TLR累积生存率（89.8%对86.1%，P = 0.787）方面均无显著差异。两组均未报告死亡病例。