Hou Lei, Wei Yi-Dong, Li Wei-Ming, Xu Ya-Wei
Department of Cardiology, The Tenth People's Hospital, Tongji University, Shanghai, China.
Saudi Med J. 2010 Feb;31(2):158-62.
To compare the transradial approach and transfemoral approach for primary percutaneous coronary intervention (PCI) in Chinese patients with acute myocardium infarction (AMI).
From August 2005 to September 2008, we randomly divided 200 AMI patients into transradial intervention (TRI) group and transfemoral intervention (TFI) group. The study took place in the Department of Cardiology, The Tenth People's Hospital, Tongji University, Shanghai, China. During the procedure, the puncture success, procedure success, infarction related artery (IRA), coronary flow, percentage of 3 vessel disease, stent used, and tirofiban used were observed. The procedural time intervals were also recorded. After the procedure, the major adverse cardiac events (MACEs) and the vascular complications were studied. In this trial, the hospital stay was also recorded.
The baseline clinical characteristics of the patients were similar in both groups. There were no statistical differences in IRA, 3 vessel disease, initial and final thrombolysis in myocardial infarction (TIMI) flow, rate of stent and tirofiban used, and procedure rate (p>0.05). No statistical differences were observed in the puncture time, cannulation time, reperfusion time, procedural time, and fluoroscopy time in both groups (p>0.05). There was no statistical difference in the incidence of MACEs between the 2 groups (p>0.05). Not only the vascular complications were lower in the TRI group (p<0.01), but also the total hospital stay was longer in the TFI group than in the TRI group (p<0.001).
Transradial intervention for Chinese patients with AMI yields comparable procedural success, and has fewer vascular access site complications compared with the TFI group.
比较经桡动脉途径和经股动脉途径在我国急性心肌梗死（AMI）患者行直接经皮冠状动脉介入治疗（PCI）中的应用效果。
2005年8月至2008年9月，我们将200例AMI患者随机分为经桡动脉介入治疗（TRI）组和经股动脉介入治疗（TFI）组。研究在中国上海同济大学附属第十人民医院心内科进行。手术过程中，观察穿刺成功率、手术成功率、梗死相关动脉（IRA）、冠状动脉血流、三支血管病变百分比、使用的支架和替罗非班情况，并记录手术时间间隔。术后，研究主要不良心脏事件（MACE）和血管并发症。本试验中还记录了住院时间。
两组患者的基线临床特征相似。IRA、三支血管病变、心肌梗死溶栓治疗（TIMI）初始和最终血流、支架和替罗非班使用率以及手术成功率方面无统计学差异（p>0.05）。两组在穿刺时间、插管时间、再灌注时间、手术时间和透视时间方面均无统计学差异（p>0.05）。两组MACE发生率无统计学差异（p>0.05）。TRI组不仅血管并发症较低（p<0.01），而且TFI组的总住院时间比TRI组长（p<0.001）。
中国AMI患者经桡动脉介入治疗的手术成功率相当，与TFI组相比，血管穿刺部位并发症更少。
