Malaiapan Yuvaraj, Leung Michael, Ahmar Walid, Hutchison Adam W, Prasad Sandhir, Katticaran Therma, Cameron James D, Harper Richard W, Meredith Ian T
Monash Cardiovascular Research Centre, MonashHEART, Southern Health & Department of Medicine (MMC), Monash University, Melbourne, Australia.
Cardiovasc Revasc Med. 2013 Jan-Feb;14(1):27-31. doi: 10.1016/j.carrev.2012.10.012. Epub 2012 Dec 8.
Radial access for primary percutaneous coronary intervention (PPCI) is well established in terms of safety and efficacy. However, there are limited data on the impact of the use of a single dedicated radial guide catheter in primary PCI using radial access.
To determine the overall cardiac catheterisation laboratory to balloon time (CCL2BT) and door to balloon (D2BT) time in transradial PPCI. To determine the impact of a single dedicated radial guide catheter on CCLD2BT and D2BT in transradial PPCI compared to conventional transfemoral PPCI.
The procedural and clinical outcomes of consecutive patients who had transradial primary PCI between 2005 and 2009 were included in this study and compared with a matched cohort who underwent transfemoral primary PCI.
Overall D2BT and inpatient MACE were similar between the radial (n=53) and femoral (n=53) groups (85 and 82 min, P=0.889; 0% and 1.8% P=0.317 respectively). An increase in the CCL2BT and procedural times was noted in the radial compared to the femoral group (34 min versus 29 min P=0.028; 15.8 min versus 11.6 min P=0.001). When a single radial guide catheter was used for the entire procedure, there was no difference in CCL2BT, D2BT and procedural times between the radial and femoral groups (31 min versus 29 min P=0.599; 74 min versus 82 min P=0.418; 50 min versus 47 min P=0.086).
The radial approach is safe and results in guideline recommended D2BT in STEMI. The use of a dedicated radial guide catheter reduces treatment time, demonstrating equivalent times to a femoral approach.
经桡动脉途径行直接经皮冠状动脉介入治疗（PPCI）在安全性和有效性方面已得到充分证实。然而，关于在经桡动脉途径的直接PCI中使用单一专用桡动脉引导导管的影响的数据有限。
确定经桡动脉PPCI中总的心导管室到球囊时间（CCL2BT）和门到球囊时间（D2BT）。确定与传统经股动脉PPCI相比，单一专用桡动脉引导导管对经桡动脉PPCI中CCL2BT和D2BT的影响。
本研究纳入了2005年至2009年间连续进行经桡动脉直接PCI的患者的手术和临床结果，并与接受经股动脉直接PCI的匹配队列进行比较。
桡动脉组（n = 53）和股动脉组（n = 53）的总体D2BT和住院期间主要不良心血管事件相似（分别为85分钟和82分钟，P = 0.889；0%和1.8%，P = 0.317）。与股动脉组相比,桡动脉组的CCL2BT和手术时间增加（34分钟对29分钟，P = 0.028；15.8分钟对11.6分钟，P = 0.001）。当在整个手术过程中使用单一桡动脉引导导管时，桡动脉组和股动脉组之间的CCL2BT、D2BT和手术时间没有差异（31分钟对29分钟，P = 0.599；74分钟对82分钟，P = 0.418；50分钟对47分钟，P = 0.086）。
桡动脉途径是安全的，并且在ST段抬高型心肌梗死中可达到指南推荐的D2BT。使用专用桡动脉引导导管可减少治疗时间，显示出与股动脉途径相当的时间。
