Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Catheterization Laboratories, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Catheter Cardiovasc Interv. 2021 May 1;97 Suppl 2:1009-1015. doi: 10.1002/ccd.29586. Epub 2021 Mar 10.
The present study compared 10-year clinical outcomes between transradial access (TRA) and transfemoral access (TFA) for left main (LM) percutaneous coronary intervention (PCI).
There are limited data regarding the long-term safety and efficacy of TRA for LM PCI.
This retrospective study evaluated consecutive patients who underwent unprotected LM PCI between January 2004 and December 2008 at Fu Wai Hospital. The exclusion criteria were age of less than 18 years and presentation with acute myocardial infarction. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), which was defined as a composite of all-cause death, myocardial infarction, stroke, and any revascularization at the 10-year follow-up.
Among 913 eligible patients, TRA was used for 417 patients (45.7%) and TFA was used for 496 patients (54.3%). The 30-day clinical outcomes were similar between the two groups. Results from the 10-year follow-up revealed that MACCE occurred in 180 patients (46.7%) from the TRA group and in 239 patients (51.2%) from the TFA group (log-rank p = .3). The TRA and TFA groups also had low and comparable cumulative rates of all-cause death (14.6% vs. 17.3%, log-rank p = .56) and cardiac death (7.9% vs. 9.1%, log-rank p = .7).
The present study revealed no significant differences in long-term clinical outcomes when TRA or TFA were used for LM PCI.
本研究比较了经桡动脉入路（TRA）和经股动脉入路（TFA）行左主干（LM）经皮冠状动脉介入治疗（PCI）的 10 年临床结果。
关于 TRA 行 LM PCI 的长期安全性和有效性的数据有限。
本回顾性研究评估了 2004 年 1 月至 2008 年 12 月期间在北京阜外医院行非保护 LM PCI 的连续患者。排除标准为年龄小于 18 岁和急性心肌梗死。主要终点是主要不良心脑血管事件（MACCE），定义为全因死亡、心肌梗死、卒中和 10 年随访时任何血运重建的复合事件。
在 913 例符合条件的患者中，417 例（45.7%）采用 TRA，496 例（54.3%）采用 TFA。两组 30 天临床结果相似。10 年随访结果显示，TRA 组发生 MACCE 的患者有 180 例（46.7%），TFA 组有 239 例（51.2%）（log-rank p =.3）。TRA 组和 TFA 组的全因死亡率（14.6%比 17.3%，log-rank p =.56）和心脏死亡率（7.9%比 9.1%，log-rank p =.7）也较低且相似。
本研究表明，TRA 或 TFA 行 LM PCI 的长期临床结果无显著差异。
