Allende-Carrera Ricardo, Viana-Rojas Jesús A, Saldierna-Galván Adriana, López-Quijano Juan M, Rivera-Arellano José de J, Leiva-Pons José L, Carrillo-Calvillo Jorge
Departamento de Cardiología, Hospital de Especialidades Médicas de la Salud, San Luis Potosí, México.
Departamento de Cardiología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City. México.
Arch Cardiol Mex. 2019;89(1):147-153. doi: 10.24875/ACME.M19000037.
The objective of the study was to describe the feasibility of single catheter intervention using the transradial approach for percutaneous coronary intervention (PCI).
The transradial approach for PCIs has fewer vascular events and complications and lower mortality rate. However, complications can result from forearm artery tortuosity, a longer learning curve and artery spasm that can complicate, delay and impede coronary artery interventions. The latter is usually exacerbated by the changing and manipulation of catheters.
We performed a study using a single catheter on patients undergoing coronary assessment and treatment. Procedural outcomes including success, procedural time, bleeding, access site complications, and contrast used were all analyzed.
We included 327 patients, of whom 70% were male. The mean age was 63.3 ± 11.1 years, mean height was 165.9 ± 7.7 cm, mean weight was 73.3 ± 11.3 kg, and mean body index was 26.5 ± 3.5 kg/m. Contrast use averaged 158.5 ± 60.5 ml. Three vessels were treated in 3% of all cases, two vessels in 32%, and one vessel in 65%. Procedural success was achieved in 94.5% of the cases. A second catheter was required in 9 cases (2.7%), and crossover to the femoral approach was performed in 9 cases (2.7%) due to a lack of support, artery spasm, difficult anatomy, or the need for a larger catheter. Three complications were related to access, including a Class 2 hematoma that was treated conservatively with no further complications.
Our study showed that using a single catheter to perform both diagnostic and therapeutic procedures has a higher success rate, lower spasm incidence, and fewer complications than reported in literature.
本研究的目的是描述经桡动脉途径使用单导管进行经皮冠状动脉介入治疗（PCI）的可行性。
PCI的经桡动脉途径血管事件和并发症较少，死亡率较低。然而，前臂动脉迂曲、较长的学习曲线以及动脉痉挛可能导致并发症，使冠状动脉介入治疗复杂化、延迟并受到阻碍。后者通常因导管的更换和操作而加剧。
我们对接受冠状动脉评估和治疗的患者使用单导管进行了一项研究。分析了包括成功率、手术时间、出血、穿刺部位并发症和造影剂用量在内的手术结果。
我们纳入了327例患者，其中70%为男性。平均年龄为63.3±11.1岁，平均身高为165.9±7.7厘米，平均体重为73.3±11.3千克，平均身体指数为26.5±3.5千克/米²。造影剂用量平均为158.5±60.5毫升。所有病例中3%治疗了三支血管，32%治疗了两支血管，65%治疗了一支血管。94.5%的病例手术成功。9例（2.7%）需要使用第二根导管，9例（2.7%）因缺乏支撑、动脉痉挛、解剖结构复杂或需要更大的导管而改为股动脉途径。3例并发症与穿刺有关，包括1例2级血肿，经保守治疗无进一步并发症。
我们的研究表明，与文献报道相比，使用单导管进行诊断和治疗操作成功率更高、痉挛发生率更低且并发症更少。
