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经桡动脉与经股动脉途径行冠状动脉旁路移植术中经皮冠状动脉介入治疗的安全性和有效性

Safety and Efficacy of Percutaneous Coronary Intervention via Transradial Versus Transfemoral Approach in Bypass Grafts.

作者信息

Dai Yuxiang, Li Chenguang, Zhang Feng, Yang Ji'e, Chang Shufu, Lu Hao, Yang Hongbo, Huang Zheyong, Qian Juying, Ge Lei, Ge Junbo

机构信息

1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China.

出版信息

Angiology. 2018 Feb;69(2):136-142. doi: 10.1177/0003319717711765. Epub 2017 Jun 12.

Abstract

We compared the efficacy and safety of the transradial approach percutaneous coronary intervention (TRA-PCI) and transfemoral approach percutaneous coronary intervention (TFA-PCI) for bypass grafts lesions. Patients (n = 184) were retrospectively enrolled. Less contrast was used during the procedure in the TRA group than in the TFA group, 201.5 (45.5) mL versus 221.5 (49.1) mL, P = .004, although fluoroscopy time was longer in the TRA group, 22.5 (6.3) minutes versus 20.3 (6.1) minutes; P = .017. The incidence of net adverse clinical events (NACEs) was lower in the TRA group than in the TFA group (3.1% vs 8.8%, respectively, P = .111). The incidence of Bleeding Academic Research Consortium type 3 and 5 bleeding (0% vs 5.5%, respectively, P = .022) was significantly lower in the TRA group than in the TFA group. For 1-year outcomes, there was no difference in the incidence of major adverse cardiovascular events (7.5% vs 9.9%, respectively, P = .569). In conclusion, TRA-PCI was associated with a lower rate of in-hospital NACEs mainly attributed to lower rates of major bleeding. The TRA-PCI showed comparable feasibility and efficacy in bypass grafts as compared with TFA-PCI when carried out by experienced operators.

摘要

我们比较了经桡动脉途径经皮冠状动脉介入治疗(TRA-PCI)和经股动脉途径经皮冠状动脉介入治疗(TFA-PCI)用于旁路移植血管病变的疗效和安全性。回顾性纳入患者(n = 184)。TRA组在手术过程中使用的造影剂少于TFA组,分别为201.5(45.5)mL和221.5(49.1)mL,P = .004,尽管TRA组的透视时间更长,分别为22.5(6.3)分钟和2

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