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经皮冠状动脉介入治疗中桡动脉远心端与经典桡动脉入路的临床效果及安全性比较。

A comparison of the clinical effects and safety between the distal radial artery and the classic radial artery approaches in percutaneous coronary intervention.

作者信息

Wang Hui, Peng Wen-Jin, Liu Yan-Hong, Ma Guan-Qun, Wang Dan, Su Bin, Liu Ying-Wu

机构信息

Department of Cardiology, Tianjin Third Central Hospital, Tianjin, China.

出版信息

Ann Palliat Med. 2020 Sep;9(5):2568-2574. doi: 10.21037/apm-19-479. Epub 2020 Jul 22.

Abstract

BACKGROUND

Compared with a classic wrist puncture for radial artery catheterization, a distal radial artery puncture has the advantage of reducing the incidence of radial artery occlusion in anatomic and physiological procedures. This study aimed to explore the difference in clinical effects between the distal radial artery and classic radial artery approaches in percutaneous coronary intervention.

METHODS

A total of 620 patients who underwent coronary angiography and/or percutaneous coronary intervention in our hospital from December 2017 to December 2018 were enrolled in this study. These patients were divided into two groups based on the puncture site: a distal radial artery group and a classic radial artery group. There were 312 patients in the radial artery group and 308 patients in the classic radial artery group. The puncture time, puncture success rate, surgery time, implanted stents, puncture site hemorrhage, hematoma, aneurysm, and iliac artery occlusion rate were observed.

RESULTS

There was no significant difference in puncture time, puncture success rate, surgery time, implanted stent, puncture site hemorrhage, hematoma and aneurysm (P>0.05), while the radial artery occlusion rate was lower in the distal radial artery group, and the difference was statistically significant (P<0.05).

CONCLUSIONS

The results of this study showed that the distal radial artery approach had a lower rate of brachial artery occlusion, indicating that it could be used as an alternative to the classic radial artery approach.

摘要

背景

与经典的桡动脉穿刺行桡动脉置管相比,桡动脉远端穿刺在解剖和生理过程中具有降低桡动脉闭塞发生率的优势。本研究旨在探讨经皮冠状动脉介入治疗中桡动脉远端与经典桡动脉入路的临床效果差异。

方法

选取2017年12月至2018年12月在我院接受冠状动脉造影和/或经皮冠状动脉介入治疗的620例患者纳入本研究。根据穿刺部位将这些患者分为两组:桡动脉远端组和经典桡动脉组。桡动脉组312例患者,经典桡动脉组308例患者。观察穿刺时间、穿刺成功率、手术时间、植入支架情况、穿刺部位出血、血肿、动脉瘤及肱动脉闭塞率。

结果

穿刺时间、穿刺成功率、手术时间、植入支架、穿刺部位出血、血肿及动脉瘤方面差异无统计学意义(P>0.05),而桡动脉远端组桡动脉闭塞率较低,差异有统计学意义(P<0.05)。

结论

本研究结果表明,桡动脉远端入路肱动脉闭塞率较低,提示其可作为经典桡动脉入路的替代方法。

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