Gul B, Stolar M, Stair B, Hermany P, Willis S, Mena-Hurtado C, Attaran R
Division of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 789 Howard Ave Dana 3rd floor, 06519, New Haven, CT, USA.
Yale Center of Analytical Sciences, Yale School of Public Health, New Haven, CT, USA.
Herz. 2020 Feb;45(1):79-85. doi: 10.1007/s00059-018-4707-1. Epub 2018 May 16.
The most common cause of procedural failure in cardiac catheterization using the transradial approach is radial artery spasm. The aim of this study was to compare the procedural success rate of the 6‑Fr Glidesheath Slender with the 6‑Fr standard sheath in transradial coronary angiography and intervention.
Patients who underwent percutaneous coronary angiography via the transradial approach through placement of a 6-Fr Glidesheath Slender or a 6-Fr standard sheath for primary radial access were prospectively enrolled in the study.
The study included 200 cases: 76 patients undergoing percutaneous coronary angiography with the Glidesheath Slender and 124 patients with the standard sheath. Failed procedures were recorded for 19 patients (9.5%), defined as inability to complete the procedure via the primary access. There was no difference in the percentage of failed cases between the Glidesheath Slender and standard sheath groups (10.5% vs. 8.9%, OR = 1.21, p = 0.8). More cases of spasm were observed in the Glidesheath Slender group compared with the standard sheath group, which was not statistically significant (7.9% vs. 5.7%, OR = 1.43, p = 0.56). Smoking, hyperlipidemia, and age influenced the procedural outcome in the Glidesheath Slender group, while body mass index, sex, and smoking impacted the procedural outcome in the standard sheath group.
There is no difference in procedural success rates, as defined by the ability to complete the procedure via primary radial access, between the 6‑Fr Glidesheath Slender and the 6‑Fr standard sheath. Our study suggests that the patient characteristics that elevate the risk of procedural failure for Glidesheath Slender may differ from those for the standard sheath.
经桡动脉途径进行心脏导管插入术时,手术失败的最常见原因是桡动脉痉挛。本研究的目的是比较6F 纤细Glidesheath导管鞘与6F标准导管鞘在经桡动脉冠状动脉造影和介入治疗中的手术成功率。
通过前瞻性纳入本研究的患者为经桡动脉途径经皮冠状动脉造影的患者,这些患者通过放置6F纤细Glidesheath导管鞘或6F标准导管鞘进行初次桡动脉穿刺。
该研究纳入200例患者:76例使用纤细Glidesheath导管鞘进行经皮冠状动脉造影,124例使用标准导管鞘。记录到19例(9.5%)手术失败,定义为无法通过初次穿刺完成手术。纤细Glidesheath导管鞘组和标准导管鞘组的失败病例百分比无差异(10.5%对8.9%,OR = 1.21,p = 0.8)。与标准导管鞘组相比,纤细Glidesheath导管鞘组观察到更多痉挛病例,但差异无统计学意义(7.9%对5.7%,OR = 1.43,p = 0.56)。吸烟、高脂血症和年龄影响纤细Glidesheath导管鞘组的手术结果,而体重指数、性别和吸烟影响标准导管鞘组的手术结果。
6F纤细Glidesheath导管鞘和6F标准导管鞘在通过初次桡动脉穿刺完成手术的能力所定义的手术成功率方面没有差异。我们的研究表明,增加纤细Glidesheath导管鞘手术失败风险的患者特征可能与标准导管鞘不同。