Cardiology Division, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Korean Circ J. 2009 Aug;39(8):304-9. doi: 10.4070/kcj.2009.39.8.304. Epub 2009 Aug 27.
Left transradial coronary angiography may result in damage of both radial arteries in patients who experienced right radial access. In some patients, the left radial artery has been used as a graft. We investigated whether graft angiography using right radial access is feasible in patients with bypass surgery to preserve the left radial artery as a future graft.
A total of 109 consecutive patients with bypass surgery who had undergone right radial access underwent graft angiography via the same access.
Sixteen (15%) patients were excluded because of the presence of a severely tortuous right subclavian artery. Bypass graft angiography via right radial or brachial access was completed successfully in 90 (97%) out of 93 patients. In 3 (3%) of patients, femoral access was needed to complete the angiography. Saphenous vein grafts were cannulated selectively in 150 (90%) of 167 grafts with satisfactory image quality and not found even on the aortogram in the other 17 (10%) grafts. Ninety-two (89%) out of 103 left mammary grafts were cannulated selectively or semi-selectively using a modified Simmons catheter, resulting in satisfactory image quality. The other 11 (11%) grafts were visualized non-selectively using a Judkins Left catheter, and resulting in acceptable image quality in 10 (91%) grafts. There were no procedure-related complications.
Graft angiography via right radial access can be performed reliably in most patients that lack severe subclavian tortuosity.
在经历过右侧桡动脉入路的患者中，左侧桡动脉可能会因冠状动脉造影而受损。在某些患者中，左侧桡动脉已被用作移植物。我们研究了在有旁路手术的患者中，通过右侧桡动脉入路进行移植物血管造影是否可行，以保留左侧桡动脉作为未来的移植物。
共有 109 例连续接受旁路手术且已接受右侧桡动脉入路的患者接受了相同入路的移植物血管造影。
16 例（15%）患者因右侧锁骨下动脉严重迂曲而被排除。93 例患者中有 90 例（97%）成功地通过右侧桡动脉或肱动脉入路完成了旁路血管造影。3 例（3%）患者需要股动脉入路才能完成血管造影。150 例（90%）的隐静脉移植物通过选择性插管获得了满意的图像质量，而在另外 17 例（10%）移植物中甚至在主动脉造影片上也未发现。使用改良的 Simmons 导管选择性或半选择性地插管 92 例（89%）左乳内动脉移植物，获得了满意的图像质量。另外 11 例（11%）移植物采用 Judkins Left 导管非选择性插管，其中 10 例（91%）获得了可接受的图像质量。无手术相关并发症。
在大多数缺乏严重锁骨下动脉迂曲的患者中，通过右侧桡动脉入路进行的移植物血管造影可以可靠地进行。
