Vorpahl Marc, Koehler Till, Foerst Jason, Panagiotopoulos Spyridon, Schleiting Heinrich, Koss Klaus, Ziegler Gunda, Brinkmann Hilmar, Seyfarth Melchior, Tiroch Klaus
Department of Cardiology, HELIOS Klinikum Wuppertal, Witten/Herdecke University, 42117 Wuppertal, Germany.
Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA.
Cardiol Res Pract. 2015;2015:862156. doi: 10.1155/2015/862156. Epub 2015 Sep 8.
Current guidelines favor the radial approach for coronary angiography. Therefore, specialty radial diagnostic catheters were designed to engage both coronary arteries with a single device. However, it is unclear if single catheters are superior to conventional catheters. A retrospective analysis was performed of consecutive right radial coronary angiographies to determine catheter use, fluoroscopy time, radiation dosage, and consumption of contrast. Procedures were performed with a single TIG catheter or conventional catheters (CONV). Procedures with coronary artery bypass grafts or ventricular angiographies were excluded. 273 transradial procedures were performed successfully. 95 procedures were performed with CONV and 178 procedures with a TIG. Crossover to additional catheters was higher in TIG (15.2%) compared to CONV (5.3%, p = 0.02). Fluoroscopy time was comparable between CONV and TIG, without crossover (2.2 ± 1.2 min versus 2.3 ± 1.2 min; n.s.), however, greater in the case of crossover for CONV (5.8 ± 0.7) and TIG (7.6 ± 3.0; p = 0.0001). Radiation dosage was similar in CONV and the TIG, without crossover (1419 ± 1075, cGy∗cm(2) versus 1690 ± 1138; n.s.), however, greater for CONV (2374 ± 620) and TIG (3733 ± 2281, p = 0.05) with crossover. Overall, the amount of contrast was greater in TIG (56 ± 13 mL) versus CONV (48 ± 3 mL; p = 0.0003). CONV femoral catheters may be the primary choice for radial approach.
当前指南倾向于采用桡动脉途径进行冠状动脉造影。因此,专门设计了桡动脉诊断导管,以便用单一装置接入两支冠状动脉。然而,单导管是否优于传统导管尚不清楚。对连续的右桡动脉冠状动脉造影进行回顾性分析,以确定导管使用情况、透视时间、辐射剂量和造影剂用量。手术采用单根TIG导管或传统导管(CONV)进行。排除冠状动脉旁路移植术或心室造影的手术。成功进行了273例经桡动脉手术。95例手术使用CONV,178例手术使用TIG。与CONV(5.3%,p = 0.02)相比,TIG更换额外导管的比例更高(15.2%)。在未更换导管的情况下,CONV和TIG的透视时间相当(2.2±1.2分钟对2.3±1.2分钟;无显著差异),然而,在CONV(5.8±0.7)和TIG(7.6±3.0;p = 0.0001)更换导管的情况下,透视时间更长。在未更换导管的情况下,CONV和TIG的辐射剂量相似(1419±1075,cGy∗cm²对1690±1138;无显著差异),然而,在更换导管的情况下,CONV(2374±620)和TIG(3733±2281,p = 0.05)的辐射剂量更高。总体而言,TIG(56±13 mL)的造影剂用量大于CONV(48±3 mL;p = 0.0003)。CONV股动脉导管可能是桡动脉途径的首选。