经桡动脉冠状动脉介入术后穿刺部位对桡动脉闭塞的影响。
Influence of Puncture Site on Radial Artery Occlusion After Transradial Coronary Intervention.
作者信息
Bi Xi-Le, Fu Xiang-Hua, Gu Xin-Shun, Wang Yan-Bo, Li Wei, Wei Li-Ye, Fan Yan-Ming, Bai Shi-Ru
机构信息
Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
出版信息
Chin Med J (Engl). 2016 Apr 20;129(8):898-902. doi: 10.4103/0366-6999.179795.
BACKGROUND
The risk of radial artery occlusion (RAO) needs particular attention in transradial intervention (TRI). Therefore, reducing vascular occlusion has an important clinical significance. The aim of this study was to determine the appropriate puncture site during TRI through comparing the occurrence of RAO between the different puncture sites to reduce the occurrence of RAO after TRI.
METHODS
We prospectively assessed the occurrence of RAO in 606 consecutive patients undergoing TRI. Artery occlusion was evaluated with Doppler ultrasound in 2 days and 1 year after the intervention. Risk factors for RAO were evaluated using a multivariate model analysis.
RESULTS
Of the 606 patients, the RAO occurred in 56 patients. Compared with TRI at 2-5 cm away from the radius styloid process, the odds ratio (OR) for occlusion risk at 0 cm and 1 cm were 9.65 (P = 0.033) and 8.90 (P = 0.040), respectively. The RAO occurred in the ratio of the arterial diameter to the sheath diameter ≤1 (OR = 2.45, P = 0.004).
CONCLUSION
Distal puncture sites (0-1 cm away from the radius styloid process) can lead to a higher rate of RAO.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT01979627; https://clinicaltrials.gov/ct2/show/NCT01979627?term = NCT01979627 and rank = 1.
背景
在经桡动脉介入治疗（TRI）中，桡动脉闭塞（RAO）的风险需要特别关注。因此，减少血管闭塞具有重要的临床意义。本研究的目的是通过比较不同穿刺部位RAO的发生率，确定TRI期间合适的穿刺部位，以降低TRI后RAO的发生率。
方法
我们前瞻性评估了606例连续接受TRI患者的RAO发生情况。在干预后2天和1年用多普勒超声评估动脉闭塞情况。使用多变量模型分析评估RAO的危险因素。
结果
606例患者中，56例发生RAO。与在距桡骨茎突2 - 5 cm处进行TRI相比，在0 cm和1 cm处闭塞风险的比值比（OR）分别为9.65（P = 0.033）和8.90（P = 0.040）。动脉直径与鞘管直径之比≤1时发生RAO（OR = 2.45，P = 0.004）。
结论
远端穿刺部位（距桡骨茎突0 - 1 cm）可导致更高的RAO发生率。
试验注册
ClinicalTrials.gov，NCT01979627；https://clinicaltrials.gov/ct2/show/NCT01979627?term = NCT01979627和rank = 1。
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