Chen Peng, Li Huijie, Zeng Chunyu, Fang Yuqiang, Shi Weibin, Zhang Xiaoqun, Yang Chengming
Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China.
Exp Ther Med. 2017 Jun;13(6):2975-2982. doi: 10.3892/etm.2017.4307. Epub 2017 Apr 5.
The transradial approach (TRA) has become an attractive alternative to the transfemoral approach (TFA) in percutaneous coronary intervention. To date, however, these two approaches have not been systematically compared in various percutaneous peripheral artery interventions (PPAIs). In the present study 258 patients with peripheral artery disease that underwent PPAI via the TRA (n=75) or the TFA (n=183) were analyzed. Clinical factors and outcomes in these two groups were compared. The puncture time was significantly longer (P<0.05) and the prevalence of artery vasospasm significantly higher (P<0.05) in patients who underwent PPAI via the TRA rather than via the TFA. However, the complication rate was significantly lower (P<0.05) and the artery compression time (P<0.05) and time bedridden (P<0.05) were significantly shorter via the TRA than via the TFA. These results suggest that PPAI via the TRA was associated with a lower complication rate, and shorter artery compression time and bedridden time than PPAI via the TFA. The TRA may be preferable for bilateral vertebral artery stenosis, whereas the TFA may be preferable for interventional treatment of carotid and subclavian artery stenosis. Therefore, the catheter length, artery support and push force should be comprehensively considered before choosing the TRA or TFA in the interventional treatment of renal artery stenosis.
在经皮冠状动脉介入治疗中,经桡动脉途径(TRA)已成为经股动脉途径(TFA)的一种有吸引力的替代方法。然而,迄今为止,在各种经皮外周动脉介入治疗(PPAI)中,这两种途径尚未得到系统比较。在本研究中,分析了258例接受PPAI的外周动脉疾病患者,其中经TRA途径(n = 75)或经TFA途径(n = 183)。比较了这两组患者的临床因素和治疗结果。与经TFA途径进行PPAI的患者相比,经TRA途径进行PPAI的患者穿刺时间明显更长(P<0.05),动脉血管痉挛的发生率明显更高(P<0.05)。然而,经TRA途径的并发症发生率明显更低(P<0.05),动脉压迫时间(P<0.05)和卧床时间(P<0.05)明显短于经TFA途径。这些结果表明,与经TFA途径进行PPAI相比,经TRA途径进行PPAI的并发症发生率更低,动脉压迫时间和卧床时间更短。对于双侧椎动脉狭窄,TRA途径可能更可取,而对于颈动脉和锁骨下动脉狭窄的介入治疗,TFA途径可能更可取。因此,在肾动脉狭窄介入治疗中选择TRA或TFA之前,应综合考虑导管长度、动脉支撑和推力。