Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China.
Chin Med J (Engl). 2012 Oct;125(19):3388-92.
Transradial coronary intervention (TRI) introduces injury to the radial artery (RA) which will affect repeat transradial coronary procedure and the quality as a bypass conduit. We sought to compare the early radial injury after TRI between first-TRI and repeat-TRI by ultrasound biomicroscopy (UBM).
A total of 1116 patients who underwent the transradial coronary procedures were enrolled. The patients depending on whether for the first time to accept transradial coronary procedure were divided into first-TRI group and repeat-TRI group. The RA was examined by UBM before and one day after the procedure.
Compared with first-TRI group, the mean RA diameter of repeat-TRI one day after the procedure decreased significantly (P < 0.05). In first-TRI group, the mean RA diameter was (2.32 ± 0.53) and (1.93 ± 0.57) mm before procedure and one day after the procedure respectively (P < 0.05). In repeat-TRI group, the mean RA diameter was (2.37 ± 0.51) and (1.79 ± 0.54) mm before procedure and one day after the procedure, respectively (P < 0.01). Compared with first-TRI group, the mean RA diameter was reduced significantly in repeat-TRI group one day after the procedure (P < 0.05). The early radial injuries and intimal thickening were compared between first-TRI and repeat-TRI. The mean intima-media thickness of RA was (0.24 ± 0.13) mm and (0.59 ± 0.28) mm before procedure and one day after the procedure in first-TRI group. The mean intima-media thickness of RA was (0.29 ± 0.16) mm and (0.68 ± 0.32) mm before procedure and one day after the procedure in repeat-TRI group. Compared with first-TRI group, the mean intimal thickening was increased significantly in repeat-TRI group one day after the procedure (P < 0.05). Intimal dissection, stenosis and occlusion were all significantly greater in repeat-TRI RAs (P < 0.05). Linear regression analysis revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.
RA early injuries were greater in repeat-TRI patients than in first-TRI patients. We first use high-resolution UBM imaging to demonstrate the rate of radial injury and revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.
经桡动脉冠状动脉介入治疗（TRI）会对桡动脉（RA）造成损伤，这将影响重复经桡动脉冠状动脉介入治疗的效果和作为旁路血管的质量。我们试图通过超声生物显微镜（UBM）比较首次 TRI 和重复 TRI 后早期 RA 损伤。
共纳入 1116 例行经桡动脉冠状动脉介入治疗的患者。根据是否首次接受经桡动脉冠状动脉介入治疗，将患者分为首次 TRI 组和重复 TRI 组。在介入治疗前和术后 1 天，使用 UBM 检查 RA。
与首次 TRI 组相比，重复 TRI 组术后 1 天 RA 平均直径明显减小（P < 0.05）。在首次 TRI 组，介入治疗前和术后 1 天 RA 平均直径分别为（2.32 ± 0.53）和（1.93 ± 0.57）mm（P < 0.05）。在重复 TRI 组，介入治疗前和术后 1 天 RA 平均直径分别为（2.37 ± 0.51）和（1.79 ± 0.54）mm（P < 0.01）。与首次 TRI 组相比，重复 TRI 组术后 1 天 RA 平均直径明显减小（P < 0.05）。比较首次 TRI 和重复 TRI 的早期桡动脉损伤和内膜增厚。首次 TRI 组 RA 的平均内中膜厚度分别为介入治疗前和术后 1 天的（0.24 ± 0.13）和（0.59 ± 0.28）mm。重复 TRI 组 RA 的平均内中膜厚度分别为介入治疗前和术后 1 天的（0.29 ± 0.16）和（0.68 ± 0.32）mm。与首次 TRI 组相比，重复 TRI 组术后 1 天内膜增厚明显增加（P < 0.05）。重复 TRI 的 RA 内膜夹层、狭窄和闭塞均明显大于首次 TRI（P < 0.05）。线性回归分析显示，直径、重复 TRI 操作和 PCI 操作是内膜增厚的独立预测因子。
重复 TRI 患者的 RA 早期损伤大于首次 TRI 患者。我们首次使用高分辨率 UBM 成像来显示桡动脉损伤的发生率，并表明直径、重复 TRI 操作和 PCI 操作是内膜增厚的独立预测因子。
