OLVG Hospital, Amsterdam, The Netherlands.
Maastricht University, Maastricht, The Netherlands.
Catheter Cardiovasc Interv. 2020 Jul;96(1):66-73. doi: 10.1002/ccd.28758. Epub 2020 Feb 20.
We compared the incidence of post-procedural radial artery occlusion (RAO) and upper extremity dysfunction (UED), in patients undergoing conventional versus slender transradial (TRA) coronary procedures.
UED was assessed by the QuickDASH, before conventional (i.e., ≥6F) and slender (i.e., "virtual" 3F to 5F) procedures, after 2 weeks and 2 months. RAO was assessed by Duplex in patients with an abnormal reversed Barbeau test (RBT). A total of 212 patients were included, UED after 2 weeks was 12%, and after 2 months 7% (p = <.001). RAO occurred in 3%. Multivariate analysis showed an OR of 0.26 (CI0.08-0.84) for UED at 2 weeks (p = .03) in favor of slender TRA. In patients with RAO, UED did not improve at 2 months (2/5, 40%, p = .046).
The occurrence of UED after TRA procedures is temporary except for patients with RAO. Slender TRA seems able to reduce short term UED.
我们比较了常规经桡动脉（TRA）与细径（虚拟 3F 至 5F）TRA 冠状动脉介入治疗后，患者发生术后桡动脉闭塞（RAO）和上肢功能障碍（UED）的发生率。
在常规（即≥6F）和细径（即“虚拟”3F 至 5F）介入治疗前、治疗后 2 周和 2 个月，采用 QuickDASH 评估 UED。RAO 通过 Duplex 检查在异常反向 Barbeau 试验（RBT）的患者中进行评估。共纳入 212 例患者，2 周后 UED 发生率为 12%，2 个月后为 7%（p<0.001）。RAO 发生率为 3%。多变量分析显示，2 周时 UED 的 OR 为 0.26（CI0.08-0.84）（p=0.03），细径 TRA 更有利。在发生 RAO 的患者中，2 个月时 UED 并未改善（5 例中有 2 例，40%，p=0.046）。
TRA 手术后 UED 的发生是暂时的，除非发生 RAO。细径 TRA 似乎能够减少短期 UED。
