Cardiology Unit, Department of Medicine, Karolinska University Hospital, Solna, N3:05, SE 171 76 Stockholm, Sweden.
Stroke. 2011 May;42(5):1475-7. doi: 10.1161/STROKEAHA.110.608638. Epub 2011 Mar 10.
Microemboli observed during coronary angiography can cause silent ischemic cerebral lesions. The aim of this study was to investigate if the number of particulate cerebral microemboli during coronary angiography is influenced by access site used.
Fifty-one patients with stable angina pectoris referred for coronary angiography were randomized to right radial or right femoral arterial access. The number of particulate microemboli passing the middle cerebral arteries was continuously registered with transcranial Doppler.
The median (minimum-maximum range) numbers of particulate emboli were significantly higher with radial 10 (1-120) than with femoral 6 (1-19) access. More particulate microemboli passed the right middle cerebral artery with the radial access.
This study indicates that the radial access used for coronary angiography generates more particulate cerebral microemboli than the femoral access and thus may influence the occurrence of silent cerebral injuries.
冠状动脉造影时观察到的微栓子可导致无症状性脑缺血性病变。本研究旨在探讨冠状动脉造影时通过颗粒状脑微栓子的数量是否受入路部位的影响。
51 例稳定性心绞痛患者行冠状动脉造影，随机分为右桡动脉或右股动脉入路。使用经颅多普勒连续记录通过大脑中动脉的颗粒状微栓子数量。
桡动脉入路的颗粒状微栓子中位数（最小-最大范围）明显高于股动脉入路的 10（1-120）比 6（1-19）。与股动脉入路相比，桡动脉入路有更多的颗粒状微栓子通过右侧大脑中动脉。
本研究表明，用于冠状动脉造影的桡动脉入路比股动脉入路产生更多的颗粒状脑微栓子，从而可能影响无症状性脑损伤的发生。
