García-Rueda Karen A, Cediel-Barrera César H, Plaza-Tenorio Maribel, Cataño-Bedoya John U, Ortiz-Uribe Juan C, Toro-Osorio Keyner, Peña-Pineda Mailyn, Senior-Sánchez Juan M
Servicio de Cardiología Clínica, Universidad de Antioquia, Medellín, Antioquia, Colombia.
Servicio de Medicina Vascular, Universidad de Antioquia, Medellín, Antioquia, Colombia.
Arch Cardiol Mex. 2022 Apr 4;92(2):230-241. doi: 10.24875/ACM.21000211.
Radial arterial access is one of the main ways to perform left heart catheterization and coronary angiography in different clinical settings, due to its lower rate of local complications and similar clinical results to when using the femoral access.
To determine the incidence of complications of radial access in interventional cardiology procedures of a hemodynamic service, as well as the impact on functionality and predictive factors for presentation.
Prospective observational cohort-type study in patients undergoing radial access coronary angiography in a university hospital with collection of demographic, clinical and ultrasound data prior to the procedure and 24 hours after it; The statistical model of logistic regression was applied to evaluate the association between the variables and the complications.
100 patients were obtained, 62% men, with a mean age of 64 years, 69% had arterial hypertension, 38% diabetes mellitus, 35% dyslipidemia, 2% peripheral arterial disease, and 10% chronic kidney disease. The reason for coronary angiography was non-ST-segment elevation acute coronary syndrome (NSTE-ACS) 65%, ST-segment elevation myocardial infarction (STEMI) 28%, pre-surgical 6%, and chronic coronary syndrome 1%. A 6 Fr introducer was used in all of them. 13% complications were documented, the most common being arterial occlusion and hematoma. Only one had implications for the functionality of the hand after a complication. After multivariate regression, height (<1.65 m) and dynamometry (<25 pounds) were found as predictive factors by area under the curve analysis using the Youden index.
The present cohort had an incidence of complications detected by ultrasound of 13%, although none of these had direct clinical implications and only one reported alteration in functionality. Height less than 1.65 m and dynamometry less than 25 pounds were found as predictive factors.
由于桡动脉穿刺局部并发症发生率较低，且临床效果与股动脉穿刺相似，因此桡动脉穿刺是在不同临床环境下进行左心导管检查和冠状动脉造影的主要途径之一。
确定血流动力学服务介入心脏病学手术中桡动脉穿刺并发症的发生率，以及对功能的影响和并发症出现的预测因素。
在一家大学医院对接受桡动脉穿刺冠状动脉造影的患者进行前瞻性观察队列研究，在手术前和术后24小时收集人口统计学、临床和超声数据；应用逻辑回归统计模型评估变量与并发症之间的关联。
共纳入100例患者，男性占62%，平均年龄64岁，69%患有动脉高血压，38%患有糖尿病，35%患有血脂异常，2%患有外周动脉疾病，10%患有慢性肾脏病。冠状动脉造影的原因是：非ST段抬高型急性冠状动脉综合征（NSTE-ACS）占65%，ST段抬高型心肌梗死（STEMI）占28%，术前占6%，慢性冠状动脉综合征占1%。所有患者均使用6F导管鞘。记录到13%的并发症，最常见的是动脉闭塞和血肿。并发症发生后只有1例对手部功能有影响。多因素回归分析后，通过使用约登指数的曲线下面积分析发现身高（<1.65米）和握力（<25磅）是预测因素。
本队列经超声检测的并发症发生率为13%，尽管这些并发症均无直接临床影响，只有1例报告有功能改变。发现身高小于1.65米和握力小于25磅是预测因素。
