Ünal Sefa, Açar Burak, Yayla Çağrı, Balci Mustafa Mücahit, Ertem Ahmet Göktuğ, Kara Meryem, Maden Orhan, Temizhan Ahmet, Tola Muharrem, Balbay Yücel
Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.
Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.
Rev Port Cardiol. 2017 Jun;36(6):409-414. doi: 10.1016/j.repc.2016.11.008. Epub 2017 May 25.
Transradial access is widely used for both diagnostic and interventional cardiac procedures. The use of transradial access offers several advantages, including decreased bleeding, fewer vascular complications, and reduced length of hospital stay and cost. However, the small size of the radial artery limits the size of the equipment that can be used via this approach. In this study we sought to investigate whether preprocedural manual heating of the radial artery facilitates radial artery puncture.
Patients undergoing transradial cardiac catheterization were randomized to subcutaneous nitroglycerin plus diltiazem or manual heating. The study endpoint was puncture score (score 1: easiest - puncture at first attempt; score 2: second attempt; score 3: third attempt; score 4: fourth attempt or more; score 5: puncture failed).
Ninety consecutive patients were enrolled in the study, 45 allocated to the drug treatment group and 45 to the heating group. Patients underwent radial artery ultrasound before catheterization. Complications were rare: one hematoma (drug treatment group) and one radial artery occlusion (heating group). Baseline demographic and clinical characteristics were similar. Baseline radial artery diameter was similar in both groups (2.41±0.46 mm and 2.29±0.48 mm in the heating and drug treatment groups, respectively). However, the median puncture score was lower in the heating group (1; interquartile range 1-2) compared to the drug treatment group (2; interquartile range 1-3; p=0.001).
Preprocedural manual heating of the radial artery facilitates radial artery puncture in patients undergoing transradial cardiac catheterization.
经桡动脉途径广泛应用于心脏诊断和介入手术。经桡动脉途径具有多种优势，包括出血减少、血管并发症较少、住院时间缩短和费用降低。然而，桡动脉管径较小限制了通过该途径使用的设备尺寸。在本研究中，我们试图探究术前对桡动脉进行手动加热是否有助于桡动脉穿刺。
接受经桡动脉心脏导管插入术的患者被随机分为皮下注射硝酸甘油加地尔硫䓬组或手动加热组。研究终点为穿刺评分（评分1：首次尝试即最容易穿刺成功；评分2：第二次尝试；评分3：第三次尝试；评分4：第四次尝试或更多次尝试；评分5：穿刺失败）。
连续90例患者纳入本研究，45例分配至药物治疗组，45例分配至加热组。患者在导管插入术前接受桡动脉超声检查。并发症罕见：药物治疗组出现1例血肿，加热组出现1例桡动脉闭塞。基线人口统计学和临床特征相似。两组的基线桡动脉直径相似（加热组和药物治疗组分别为2.41±0.46mm和2.29±0.48mm）。然而，加热组的中位穿刺评分（1；四分位间距1 - 2）低于药物治疗组（2；四分位间距1 - 3；p = 0.001）。
术前对桡动脉进行手动加热有助于接受经桡动脉心脏导管插入术的患者进行桡动脉穿刺。
