Yu Weiwei, Hu Pengfei, Wang Shen, Yao Liping, Wang Hao, Dou Liping, Lu Ming, Bo Gang, Yu Xixia, Chen Jingwen, Chen Chao, Luo Ying, Yang Ming, Dong Zhuqin, Huang Shuwei
Zhejiang Chinese Medical University.
Department of Cardiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University.
Medicine (Baltimore). 2020 Jan;99(3):e18330. doi: 10.1097/MD.0000000000018330.
To explore the feasibility and safety of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via the distal radial artery in the anatomical snuffbox.
Ninety two patients who underwent CAG or PCI through distal radial artery access at The Second Affiliated Hospital of Zhejiang Chinese Medical University from September 2017 to March 2018 were included in our study. We collected baseline characteristics, number, and duration of arterial punctures, procedural success rate, postoperative compression time, the numerical rating scale (NRS) scores at 3 hours after procedure, complications, hospitalization duration.
The mean age was 69 ± 11years (44-92 years), and there were 57 males (62.0%). The diameter of the right distal radial artery and the more proximal right radial artery were 0.171 ± 0.05 cm, 0.213 ± 0.06 cm, respectively. On average, the number of puncture attempts was 1.52 ± 0.81, access time was 2.3 ± 1.78 minutes (0.33 - 8.72 minutes), access success was 95.7%, the postoperative compression time was 3.41 ± 0.76 hours (2-6 hours), the NRS scores at 3 hours was 1.53 ± 0.72 (1-4), and the mean hospitalization duration was 7.13 ± 4.02 days. Four patients underwent left distal radial artery access and 88 patients underwent right distal radial artery access. There were 3 local hematomas after procedure and 2 patients had vasospasm. There were no cases of major bleeding, arteriovenous fistula, radial artery occlusion, or hand numbness.
Cardiac catheterization through the distal radial artery in the snuffbox is safe and feasible. The right distal radial artery access can be routinely carried out.
探讨经解剖鼻烟壶处桡动脉远心端行冠状动脉造影（CAG）及经皮冠状动脉介入治疗（PCI）的可行性与安全性。
纳入2017年9月至2018年3月在浙江中医药大学附属第二医院经桡动脉远心端途径行CAG或PCI的92例患者。收集患者的基线特征、动脉穿刺次数及持续时间、手术成功率、术后压迫时间、术后3小时数字评分量表（NRS）评分、并发症及住院时间。
患者平均年龄为69±11岁（44 - 92岁），男性57例（62.0%）。右侧桡动脉远心端及近心端直径分别为0.171±0.05cm、0.213±0.06cm。平均穿刺尝试次数为1.52±0.81次，穿刺时间为2.3±1.78分钟（0.33 - 8.72分钟），穿刺成功率为95.7%，术后压迫时间为3.41±0.76小时（2 - 6小时），术后3小时NRS评分为1.53±0.72（1 - 4），平均住院时间为7.13±4.02天。4例患者经左侧桡动脉远心端途径，88例患者经右侧桡动脉远心端途径。术后发生3例局部血肿，2例患者出现血管痉挛。无大出血、动静脉瘘、桡动脉闭塞或手部麻木病例。
经鼻烟壶处桡动脉远心端行心导管检查安全可行。右侧桡动脉远心端途径可常规开展。
