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超声引导与传统经桡动脉远端入路在冠状动脉造影及介入治疗中的对比分析。

A Comparative Analysis between Ultrasound-Guided and Conventional Distal Transradial Access for Coronary Angiography and Intervention.

机构信息

Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan.

出版信息

J Interv Cardiol. 2020 Sep 8;2020:7342732. doi: 10.1155/2020/7342732. eCollection 2020.

DOI:10.1155/2020/7342732
PMID:32982609
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7495218/
Abstract

OBJECTIVES

To compare feasibility and safety between ultrasound-guided and conventional distal transradial access (dTRA).

BACKGROUND

Distal transradial access, a new technique for coronary angiography (CAG) and percutaneous coronary interventions (PCI), is safe and feasible and will become popular worldwide. Ultrasound-guided dTRA has been advocated to reduce failure rate and access-site complications. However, to date, the comparison of feasibility and safety between ultrasound-guided and conventional dTRA has not been reported.

METHOD

Overall, 137 patients (144 procedures) who underwent CAG or PCI using dTRA between September 2018 and February 2019 were investigated. These patients were classified into two groups: C (dTRA with conventional punctures; 76 patients, 79 procedures) and U (dTRA with ultrasound-guided punctures; 61 patients, 65 procedures) groups. Successful procedural rate, procedural outcomes, and complication rate during hospital stays were compared between the two groups.

RESULTS

The procedural success rate was significantly higher in the U group than in the C group (97% vs. 87%, =0.0384). However, the rate of PCI, puncture time, total fluoroscopy time, the volume of contrast medium, the rate of access-site ecchymosis, and incidence of nerve disorder were similar between the two groups. Additionally, radial artery occlusion after the procedure did not occur in this study.

CONCLUSION

The ultrasound-guided dTRA for CAG or PCI was associated with a lower failure rate than conventional dTRA. However, there were no significant differences in puncture time and complication rate between the two procedures.

摘要

目的

比较超声引导下与传统经桡动脉远端入路（dTRA）的可行性和安全性。

背景

经桡动脉远端入路是一种新的冠状动脉造影（CAG）和经皮冠状动脉介入治疗（PCI）技术，安全可行，将在全球范围内普及。超声引导下的 dTRA 已被提倡用于降低失败率和入路部位并发症。然而，迄今为止，超声引导下与传统 dTRA 的可行性和安全性比较尚未报道。

方法

2018 年 9 月至 2019 年 2 月，共对 137 例（144 例次）接受 dTRA 行 CAG 或 PCI 的患者进行了研究。这些患者被分为两组：C 组（dTRA 采用传统穿刺；76 例，79 例次）和 U 组（dTRA 采用超声引导穿刺；61 例，65 例次）。比较两组间的手术成功率、手术结果和住院期间并发症发生率。

结果

U 组的手术成功率明显高于 C 组（97% vs. 87%，=0.0384）。然而，两组间的 PCI 率、穿刺时间、总透视时间、造影剂用量、入路部位瘀斑发生率和神经障碍发生率相似。此外，本研究中术后未发生桡动脉闭塞。

结论

与传统 dTRA 相比，超声引导下的 dTRA 用于 CAG 或 PCI 的失败率较低。然而，两种操作的穿刺时间和并发症发生率无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/0aa507306fa3/JITC2020-7342732.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/ddfb551fe402/JITC2020-7342732.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/5f80518d376e/JITC2020-7342732.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/e42f698e2295/JITC2020-7342732.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/da05c6899fba/JITC2020-7342732.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/a472b5271617/JITC2020-7342732.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/0aa507306fa3/JITC2020-7342732.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/ddfb551fe402/JITC2020-7342732.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/5f80518d376e/JITC2020-7342732.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/e42f698e2295/JITC2020-7342732.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/da05c6899fba/JITC2020-7342732.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/a472b5271617/JITC2020-7342732.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fe/7495218/0aa507306fa3/JITC2020-7342732.006.jpg

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