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左桡骨远端入路在经皮冠状动脉介入治疗分叉病变中的可行性与安全性

Feasibility and Safety of the Left Distal Radial Approach in Percutaneous Coronary Intervention for Bifurcation Lesions.

作者信息

Lee Oh-Hyun, Roh Ji Woong, Im Eui, Cho Deok-Kyu, Jeong Myung Ho, Choi Donghoon, Kim Yongcheol

机构信息

Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin 16995, Korea.

Department of Cardiology, Chonnam National University Hospital, Gwangju 61469, Korea.

出版信息

J Clin Med. 2021 May 19;10(10):2204. doi: 10.3390/jcm10102204.

Abstract

Recently, the left distal radial approach (DRA) for percutaneous coronary intervention (PCI) has been shown to be a feasible option, but there are limited data regarding the feasibility of performing bifurcation PCI via the left DRA. Therefore, this study aimed to describe our experience with the contemporary left DRA to perform PCI of bifurcation lesions. Between December 2017 and December 2019, we identified 106 patients treated with bifurcation PCI via the left DRA. We evaluated the success rate of PCI, access-site complications including major bleeding requiring surgery or transfusion, hematoma, distal and forearm radial artery occlusion, and 30-day mortality. Eleven patients (10.4%) treated with left main bifurcation and true bifurcations accounted for 39.6% of cases, with the left anterior descending artery/diagonal branch being the most frequent bifurcation site (57.5%, 61/106). PCI was performed using a 6-French guiding catheter in 101 (95.3%) cases. Successful PCI for bifurcation lesions via the left DRA was achieved in all 106 patients without access-site cross-over. There was no major bleeding, distal and forearm radial artery occlusion, forearm hematoma, or mortality at 30 days. The left DRA is a safe and feasible alternative access site for bifurcation PCI in selected patients.

摘要

最近,经皮冠状动脉介入治疗(PCI)的左桡动脉远端入路(DRA)已被证明是一种可行的选择,但关于经左DRA进行分叉病变PCI可行性的数据有限。因此,本研究旨在描述我们使用当代左DRA进行分叉病变PCI的经验。在2017年12月至2019年12月期间,我们确定了106例经左DRA进行分叉病变PCI的患者。我们评估了PCI的成功率、包括需要手术或输血的大出血、血肿、桡动脉远端和前臂闭塞在内的穿刺部位并发症以及30天死亡率。11例(10.4%)接受左主干分叉和真性分叉治疗的患者占病例的39.6%,左前降支/对角支是最常见的分叉部位(57.5%,61/106)。101例(95.3%)患者使用6F引导导管进行PCI。所有106例患者均通过左DRA成功完成分叉病变PCI,且无穿刺部位交叉。30天时无大出血、桡动脉远端和前臂闭塞、前臂血肿或死亡。对于选定患者,左DRA是分叉病变PCI的安全可行的替代穿刺部位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0a4/8161320/b62a997ddf54/jcm-10-02204-g001.jpg

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