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用于冠状动脉旁路移植术的内镜下桡动脉采集:前50例患者的初步临床经验及结果

Endoscopic radial artery harvesting for coronary artery bypass grafting: the initial clinical experience and results of the first 50 patients.

作者信息

Ito Nobuhisa, Tashiro Tadashi, Morishige Noritsugu, Iwahashi Hidehiko, Nishimi Masaru, Hayashida Yoshio, Takeuchi Kazuma, Minematsu Noritoshi, Kuwahara Go, Sukehiro Yuta

机构信息

Department of Cardiovascular Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.

出版信息

Heart Surg Forum. 2009 Dec;12(6):E310-5. doi: 10.1532/HSF98.20091080.

Abstract

BACKGROUND

The radial artery (RA) is a commonly used arterial conduit in coronary artery bypass grafting (CABG). Traditional open-vessel harvest often leads to postoperative wound complications and cosmetic problems. Endoscopic RA harvesting (ERAH) has been widely used to prevent these problems. The purpose of this study was to assess these problems and graft patency in the first 50 patients who underwent ERAH.

METHODS

Between February 2006 and October 2007, 50 patients underwent ERAH with the VasoView system (Boston Scientific). These patients were compared with 50 patients who underwent the traditional open technique.

RESULTS

The mean age was 62.8 years in both groups. All RAs were successfully harvested. No conversion was made from ERAH to the traditional open technique. The mean harvesting time (forearm ischemic time) was 27.4 + or - 6.5 minutes, and the mean length of the RA in the ERAH group was 18.5 cm. Neither wound complications, such as wound infection and skin necrosis, nor severe neurologic complications were recorded. The patency rate was 95.9% (95/99) in the ERAH group and 94% (94/100) in the open group.

CONCLUSION

ERAH can be performed safely, and the early results are satisfactory. Endoscopic vessel harvesting is therefore recommended as the technique of choice for RA harvesting.

摘要

背景

桡动脉(RA)是冠状动脉旁路移植术(CABG)中常用的动脉管道。传统的开放血管采集方法常常导致术后伤口并发症和美观问题。内镜下桡动脉采集(ERAH)已被广泛应用以预防这些问题。本研究的目的是评估接受ERAH的前50例患者的这些问题及移植物通畅情况。

方法

2006年2月至2007年10月期间,50例患者使用VasoView系统(波士顿科学公司)接受了ERAH。将这些患者与50例接受传统开放技术的患者进行比较。

结果

两组患者的平均年龄均为62.8岁。所有桡动脉均成功采集。没有从ERAH转为传统开放技术的情况。平均采集时间(前臂缺血时间)为27.4±6.5分钟,ERAH组桡动脉的平均长度为18.5厘米。未记录到伤口并发症,如伤口感染和皮肤坏死,也未记录到严重的神经并发症。ERAH组的通畅率为95.9%(95/99),开放组为94%(94/100)。

结论

ERAH可以安全进行,早期结果令人满意。因此,建议将内镜下血管采集作为桡动脉采集的首选技术。

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