Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland; Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland.
Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
Kardiol Pol. 2020 Jun 25;78(6):529-536. doi: 10.33963/KP.15286. Epub 2020 Apr 8.
The association between periprocedural complications and the type of vascular access in patients treated with percutaneous coronary intervention (PCI) and rotational atherectomy (RA) has not been investigated as frequently as in an overall group of patients treated with PCI.
The aim of this study was to assess the associations between the type of vascular access and selected periprocedural complications in a group of patients treated with PCI and RA.
ased on a nationwide Polish registry (National Registry of Percutaneous Coronary Interventions [ORPKI]), we analyzed 536 826 patients treated with PCI between the years 2014 and 2018. The study included 2713 patients (0.5% of the overall group of patients treated with PCI [n = 536 826]) treated with PCI and RA. Among them, 1018 (37.5%) were treated via femoral access, and 1653 (60.9%) via radial access. Subsequently, these patients were subject to comparison, which was proceeded by propensity score matching.
Following propensity score matching, multiple regression analysis revealed that patients undergoing PCI via femoral access experienced coronary artery perforation significantly less frequently than those managed via radial access (odds ratio, 0.29; 95% CI, 0.08-0.92; P = 0.04). We did not observe any significant associations between the type of vascular access and the periprocedural mortality rate (P = 0.99), cardiac arrest (P = 0.41), puncture‑site bleeding (P = 0.99), allergic reaction (P = 0.32), myocardial infarction (P = 0.48), no‑reflow phenomenon (P = 0.82), or the overall complication rate (P = 0.31).
In patients treated with PCI and RA, femoral access is associated with a lower rate of coronary artery perforations as compared with radial access.
在接受经皮冠状动脉介入治疗（PCI）和旋磨术（RA）的患者中，围手术期并发症与血管入路类型之间的关系尚未像在接受 PCI 的总体患者群体中那样经常被研究。
本研究旨在评估 PCI 和 RA 治疗患者中血管入路类型与选定围手术期并发症之间的关联。
基于波兰全国登记处（全国经皮冠状动脉介入治疗登记处 [ORPKI]），我们分析了 2014 年至 2018 年期间接受 PCI 治疗的 536826 例患者。研究纳入了 2713 例（0.5%接受 PCI 治疗的总体患者 [n=536826]）接受 PCI 和 RA 治疗的患者。其中，1018 例（37.5%）经股动脉入路治疗，1653 例（60.9%）经桡动脉入路治疗。随后，对这些患者进行了比较，并进行了倾向评分匹配。
在进行倾向评分匹配后，多元回归分析显示，经股动脉入路行 PCI 的患者发生冠状动脉穿孔的频率明显低于经桡动脉入路治疗的患者（比值比，0.29；95%置信区间，0.08-0.92；P=0.04）。我们没有观察到血管入路类型与围手术期死亡率（P=0.99）、心脏骤停（P=0.41）、穿刺部位出血（P=0.99）、过敏反应（P=0.32）、心肌梗死（P=0.48）、无复流现象（P=0.82）或总并发症发生率（P=0.31）之间存在任何显著关联。
在接受 PCI 和 RA 治疗的患者中，与桡动脉入路相比，股动脉入路与较低的冠状动脉穿孔发生率相关。
