经桡动脉与经股动脉途径在经皮冠状动脉造影及血管成形术中的比较：来自印度北部一家中心的七年回顾性经验。
Comparison of transradial and transfemoral artery approach for percutaneous coronary angiography and angioplasty: a retrospective seven-year experience from a north Indian center.
作者信息
Tewari Satyendra, Sharma Naveen, Kapoor Aditya, Syal Sanjeev Kumar, Kumar Sudeep, Garg Naveen, Goel Pravin K
机构信息
Professor, Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India.
出版信息
Indian Heart J. 2013 Jul-Aug;65(4):378-87. doi: 10.1016/j.ihj.2013.06.020. Epub 2013 Jul 12.
BACKGROUND
With the increasing prevalence of coronary artery disease, percutaneous coronary artery procedures have become even more important. Our study has compared transradial to transfemoral artery approach for coronary procedures in Indian population.
AIMS AND OBJECTIVE
Comparison of transradial and transfemoral artery approach for percutaneous coronary procedures.
MATERIAL & METHODS: 26,238 patients, who underwent percutaneous coronary artery procedures, were divided into two groups depending upon transradial and transfemoral artery approach and compared for the various demographic and clinical characteristics, risk factors profile, vascular access and procedural details.
RESULTS
26,238 patients underwent percutaneous coronary procedures at our center. 81% were male and 19% were female. 55.65% and 44.35% procedures were done through transfemoral and transradial approach, respectively. 17,417 (66.38%) coronary angiographies were done, out of which 53.92% were transradial and 46.08% were transfemoral procedures. 8821 (33.62%) Percutaneous Transluminal Coronary Angioplasty (PTCA) were done, out of which 25.46% and 74.54% were done through transradial and transfemoral approach, respectively. Mean fluoroscopy time was 4.40 ± 3.55 min for transradial and 3.30 ± 3.66 min for transfemoral CAG (p < 0.001). For PTCA mean fluoroscopy time was 13.53 ± 2.53 min for transradial and 12.61 ± 9.524 min for transfemoral PTCA (p < 0.001). Minor and major procedure related complications and total duration of hospital stay were lower in transradial as compared to transfemoral group.
CONCLUSION
The number of percutaneous transradial procedures have increased significantly with reduced complication rates and comparable success rate to transfemoral approach, along with the additional benefits to patient in terms of patient comfort, preference and reduced cost of health delivery.
背景
随着冠状动脉疾病患病率的不断上升，经皮冠状动脉介入手术变得愈发重要。我们的研究比较了印度人群中经桡动脉与经股动脉途径进行冠状动脉介入手术的情况。
目的
比较经皮冠状动脉介入手术中经桡动脉和经股动脉途径。
材料与方法
26238例接受经皮冠状动脉介入手术的患者，根据经桡动脉和经股动脉途径分为两组，比较其各种人口统计学和临床特征、危险因素概况、血管入路及手术细节。
结果
我们中心有26238例患者接受了经皮冠状动脉介入手术。其中男性占81%，女性占19%。分别有55.65%和44.35%的手术通过经股动脉和经桡动脉途径进行。共进行了17417例（66.38%）冠状动脉造影，其中53.92%为经桡动脉手术，46.08%为经股动脉手术。进行了8821例（33.62%）经皮腔内冠状动脉成形术（PTCA），其中分别有25.46%和74.54%通过经桡动脉和经股动脉途径进行。经桡动脉冠状动脉造影的平均透视时间为4.40±3.55分钟，经股动脉冠状动脉造影为3.30±3.66分钟（p<0.001）。经桡动脉PTCA的平均透视时间为13.53±2.53分钟，经股动脉PTCA为12.61±9.524分钟（p<0.001）。与经股动脉组相比，经桡动脉组的轻微和严重手术相关并发症以及住院总时长更低。
结论
经皮经桡动脉手术的数量显著增加，并发症发生率降低，成功率与经股动脉途径相当，并且在患者舒适度、偏好以及降低医疗成本方面给患者带来了额外益处。
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