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经桡动脉左心室心肌内膜活检:安全性和有效性评估。

Transradial left ventricular endomyocardial biopsy: assessment of safety and efficacy.

机构信息

Abteilung für Kardiologie, Robert Bosch Krankenhaus Stuttgart, Auerbachstr. 110, 70376, Stuttgart, Germany,

出版信息

Clin Res Cardiol. 2015 Sep;104(9):773-81. doi: 10.1007/s00392-015-0844-1. Epub 2015 Apr 2.

Abstract

BACKGROUND

We aimed at assessing the safety and efficacy of a systematic transradial approach for left ventricular endomyocardial biopsy using a new hydrophilic sheathless guiding catheter.

METHODS AND RESULTS

Forty-two consecutive patients were included. The transradial success rate was 98% (41 of 42). In one case, cross over to femoral access due to irreversible spasm of the right radial artery was necessary. No radial spasm was observed in the other 41 patients. Depending on the indication, several other procedures, such as coronary angiography or ventricular angiography, were additionally performed through the same transradial access site. Median fluoroscopy time was 7.9 min. The mean dose area product was 1867 cGy × cm(2). All biopsy samples were graded as good or excellent quality. No patient had any complications. Immediate post-procedural ambulation could be achieved in all patients. Radial artery patency was confirmed by duplex sonography 24 h after removal of the guide.

CONCLUSION

The present study demonstrates safety and efficacy of a systematic transradial access for left ventricular EMB using a highly hydrophilic sheathless guiding catheter. This is of clinical importance since this new technique may overcome critical limitations of the common approach.

摘要

背景

我们旨在评估使用新型亲水无鞘引导导管进行系统性经桡动脉左心室心内膜心肌活检的安全性和有效性。

方法和结果

共纳入 42 例连续患者。经桡动脉入路成功率为 98%(41/42)。在 1 例患者中,由于右桡动脉不可逆性痉挛,需要交叉至股动脉入路。在其余 41 例患者中未观察到桡动脉痉挛。根据适应证,通过同一经桡动脉入路还进行了其他一些操作,如冠状动脉造影或心室造影。透视中位时间为 7.9 分钟。平均剂量面积乘积为 1867 cGy×cm(2)。所有活检样本均评为良好或优秀质量。无患者发生任何并发症。所有患者均能立即在术后下床活动。在取出导引导管后 24 小时通过双功能超声确认桡动脉通畅。

结论

本研究表明使用高度亲水无鞘引导导管进行系统性经桡动脉左心室 EMB 的安全性和有效性。由于这项新技术可能克服了常见方法的关键局限性,因此具有重要的临床意义。

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