The Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Mayo Foundation, Rochester, Minnesota 55905, USA.
Catheter Cardiovasc Interv. 2010 Dec 1;76(7):911-6. doi: 10.1002/ccd.22742. Epub 2010 Oct 7.
Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore nonhydrophilic guiding catheters.
A major limitation of transradial percutaneous coronary intervention (PCI) is the inability to use large guides because of the relatively small size of the radial artery.
We identified consecutive patients who had transradial PCI between September 2009 and March 2010 using large-bore guides (7 or 8 Fr) with a sheathless technique.
Ten patients were identified (90% men, mean age 68.8 ± 9.8 years). Indications for PCI were stable angina (60%) and acute coronary syndrome (40%). Treatment was attempted on 15 vessels. Bifurcation lesions were present in six patients. One patient had a chronic total occlusion, one had a saphenous vein bypass graft lesion requiring filter wire placement prior to intervention, and one patient required rotational atherectomy. In the majority of patients (60%) a 7-Fr guiding catheter was used for the intervention; 8-Fr guide catheters were used four patients. PCI was unsuccessful in one vessel; this was a completely occluded obtuse marginal which could not be crossed. There were no radial artery access site complications and in no case was cross-over to a femoral artery access site required. One minor coronary complication occurred.
Sheathless transradial PCI using standard large-bore guiding catheters is a safe and effective method for treatment of complex lesions.
我们旨在报告使用无鞘技术和标准大口径非亲水性引导导管进行复杂经桡动脉介入治疗的初步经验。
经桡动脉经皮冠状动脉介入治疗（PCI）的一个主要限制是由于桡动脉相对较小的尺寸，无法使用大的引导器。
我们确定了 2009 年 9 月至 2010 年 3 月期间使用无鞘技术的大口径导引导管（7 或 8Fr）进行经桡动脉 PCI 的连续患者。
确定了 10 例患者（90%为男性，平均年龄 68.8±9.8 岁）。PCI 的适应证为稳定型心绞痛（60%）和急性冠状动脉综合征（40%）。对 15 个血管进行了治疗。6 例患者存在分叉病变。1 例患者存在慢性完全闭塞，1 例患者存在隐静脉旁路移植病变，需要在介入前放置滤线器，1 例患者需要旋转动脉粥样切除术。在大多数患者（60%）中，使用 7Fr 导引导管进行介入治疗；4 例患者使用 8Fr 导引导管。1 个血管的 PCI 不成功；这是一个完全闭塞的钝缘支，无法通过。没有桡动脉入路并发症，没有一例需要交叉到股动脉入路。发生 1 例轻微的冠状动脉并发症。
使用标准大口径导引导管的无鞘经桡动脉 PCI 是治疗复杂病变的安全有效的方法。
