Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis Amsterdam, The Netherlands.
Heart. 2010 Sep;96(17):1341-4. doi: 10.1136/hrt.2010.196824.
Primary percutaneous coronary intervention (PPCI) has been acknowledged by the most recent European guidelines to be the preferred treatment for ST elevation myocardial infarction (STEMI). Patients undergoing PPCI are expected to receive a broad spectrum of anticoagulants and antiplatelet agents, which increases the risk of bleedings, in most cases, at the site of vascular access. The burden of bleeding complications after PPCI is as negative as that of ischemic complications not only on in-hospital morbidity, but also on mid- and long-term survival. Owing to the unique features of the radial artery, transradial approach (TRA) seems able to overcome most of the problems related to vascular access particularly in case of STEMI. In this short review we discuss the results of the latest studies and we highlight not only the safety and feasibility of TRA-PPCI, but also the advantages in terms of morbidity and mortality. We finally report on our experience at OLVG Amsterdam, and how TRA can also change the logistics in case of a PPCI programme (short stay).
经皮冠状动脉介入治疗（PPCI）已被最新的欧洲指南认可为 ST 段抬高型心肌梗死（STEMI）的首选治疗方法。接受 PPCI 的患者预计将接受广泛的抗凝和抗血小板药物治疗，这会增加大多数情况下血管入路部位出血的风险。与缺血性并发症一样，PPCI 后出血并发症的负担不仅对住院期间的发病率有影响，而且对中期和长期生存率也有影响。由于桡动脉的独特特征，经桡动脉途径（TRA）似乎能够克服与血管入路相关的大多数问题，特别是在 STEMI 的情况下。在这篇简短的综述中，我们讨论了最新研究的结果，不仅强调了 TRA-PPCI 的安全性和可行性，还强调了在发病率和死亡率方面的优势。我们最后报告了我们在阿姆斯特丹 OLVG 的经验，以及 TRA 如何改变 PPCI 计划（短期停留）的后勤工作。
