Wang Yan-Bo, Fu Xiang-Hua, Wang Xue-Chao, Gu Xin-Shun, Zhao Yun-Jun, Hao Guo-Zhen, Jiang Yun-Fa, Li Shi-Qiang, Wu Wei-Li, Fan Wei-Ze
Department of Cardiology, Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang 050000, PR China.
J Invasive Cardiol. 2012 Aug;24(8):412-6.
Early percutaneous coronary intervention (PCI) following thrombolysis may be beneficial in patients with ST-segment elevation myocardial infarction (STEMI) who were admitted at a non-PCI hospital. The aim of this study was to evaluate the safety and efficacy of the radial artery as a vascular route for early PCI following thrombolysis in patients with STEMI.
All consecutive STEMI patients within 12 hours after thrombolysis were enrolled, and eligible patients were randomly assigned to either transfemoral (TFI group) or transradial catheterization (TRI group). Several time intervals were measured. The puncture success rate and ambulation time were assessed. The vascular access-site complications were also assessed after the PCI procedure, and the incidence of major adverse cardiac events (MACE) in hospital was observed.
A total of 119 cases were enrolled, with 60 in the TRI group and 59 in the TFI group. There were no significant differences in transfer time and total procedure time. The puncture time in the TRI group was not significantly different compared to the TFI group. The time between PCI and ambulation in the TRI group was shorter than in the TFI group. There was a trend toward lower in the incidence of bleeding complications and vascular complications in the TRI group.
TRI for STEMI patients following intravenous thrombolysis was as safe and feasible as TFI, with a trend toward lower incidence of bleeding complications and vascular complications.
对于在非PCI医院就诊的ST段抬高型心肌梗死（STEMI）患者，溶栓后早期经皮冠状动脉介入治疗（PCI）可能有益。本研究的目的是评估桡动脉作为STEMI患者溶栓后早期PCI血管通路的安全性和有效性。
纳入所有溶栓后12小时内连续的STEMI患者，符合条件的患者被随机分配至经股动脉（TFI组）或经桡动脉导管插入术（TRI组）。测量了几个时间间隔。评估穿刺成功率和下床活动时间。PCI术后还评估了血管穿刺部位并发症，并观察了住院期间主要不良心脏事件（MACE）的发生率。
共纳入119例患者，TRI组60例，TFI组59例。转运时间和总手术时间无显著差异。TRI组的穿刺时间与TFI组相比无显著差异。TRI组PCI至下床活动的时间比TFI组短。TRI组出血并发症和血管并发症的发生率有降低趋势。
STEMI患者静脉溶栓后行TRI与TFI一样安全可行，出血并发症和血管并发症的发生率有降低趋势。
