Hôpital Marie Lannelongue, Le Plessis Robinson, France.
Catheter Cardiovasc Interv. 2010 Nov 1;76(5):668-72. doi: 10.1002/ccd.22552.
We aimed to assess the efficiency of a long hydrophilic sheath in reducing radial spasm for transradial approach.
Despite a lower access site complication rate, cardiac catheterization using transradial approach is not widely used. Radial spasm is one of the main issues for transradial angiography and percutaneous interventions. We assumed that radial artery protection using a long hydrophilic-coated sheath would reduce radial spasm compared to a bare short sheath.
Three hundred and fifty one patients (pts) admitted for transradial coronary angiography ± percutaneous coronary interventions were randomly assigned to a long hydrophilic-coated or a short sheath (control group). Primary end point was the occurrence of a radial spasm defined by significant patient pain evaluated by scale score (>4) or significant catheter frictions during manipulation. Procedure failure, radial occlusion, and local complications were also assessed.
Radial spasm was significantly reduced when using the long-coated compared to the short sheath in 7 (4%) vs. 32 pts (18%) P < 0.001. No difference was found regarding procedure failure respectively 1.2% vs. 0.6%, local complication 0.6% vs. 1.2%, and radial occlusion 3.5% vs. 3.5%.
Radial artery protection using the long hydrophilic-coated sheath was efficient in the prevention of radial spasm for transradial approach. © 2010 Wiley-Liss, Inc.
我们旨在评估长亲水鞘在减少经桡动脉入路中桡动脉痉挛方面的效率。
尽管桡动脉入路的穿刺部位并发症发生率较低，但心脏导管术并不广泛应用。桡动脉痉挛是经桡动脉血管造影和经皮介入的主要问题之一。我们假设使用长亲水涂层鞘管进行桡动脉保护，与使用短裸鞘管相比，可减少桡动脉痉挛。
351 名接受经桡动脉冠状动脉造影术±经皮冠状动脉介入治疗的患者被随机分配至长亲水涂层鞘管组或短鞘管（对照组）组。主要终点是桡动脉痉挛的发生，定义为患者疼痛明显（评分>4）或在操作过程中导管明显摩擦。还评估了手术失败、桡动脉闭塞和局部并发症。
与短鞘管相比，使用长涂层鞘管时桡动脉痉挛显著减少，分别有 7 名（4%）和 32 名（18%）患者发生（P<0.001）。在手术失败率（分别为 1.2%和 0.6%）、局部并发症发生率（分别为 0.6%和 1.2%）和桡动脉闭塞率（分别为 3.5%和 3.5%）方面，两组间无差异。
长亲水涂层鞘管的桡动脉保护在预防经桡动脉入路中的桡动脉痉挛方面是有效的。©2010 Wiley-Liss，Inc.
