Department of Internal Medicine, Division of Cardiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea.
Medicina (Kaunas). 2021 Oct 18;57(10):1124. doi: 10.3390/medicina57101124.
Appropriate catheter selection when conducting transradial coronary angiography (CAG) helps shorten examination time, preventing vascular complications and lowering medical expense. However, catheter selection is made based on the practitioner's experience in almost all cases. Therefore, we undertook this study to define radiologic and echocardiographic indices that would enable physicians to anticipate appropriate catheter selection. This is a retrospective study of 244 undergoing transradial diagnostic CAG at an established center from February 2006 to April 2014. Patients who successfully underwent angiography with a JL3.5 catheter were defined as the control group, and patients who successfully underwent angiography after the catheter was replaced with a JL4.0 or higher were defined as the switched group. To identify predictors for appropriate catheter selection, radiologic and echocardiographic indices were analyzed. A total of 122 patients in the switched group and 122 patients in the control group were analyzed in this study. Average age was 64.65 ± 8.6 years. In the radiographic index, the switched group exhibited a significantly higher mediastinal-thoracic ratio (0.27 ± 0.05 vs. 0.23 ± 0.03, < 0.001. Additionally, the mediastinal-cardiac ratio was significantly greater in the switched group (0.50 ± 0.08 vs. 0.45 ± 0.05, < 0.001). Aortic root diameter, which is used here as the echocardiographic index, was significantly larger in the switched group compared to the control group (34.94 ± 4.18 mm vs. 32.66 ± 3.99 mm, < 0.001). In the multivariable logistic regression model, mediastinal-cardiac ratio (OR 5.197, 95% CI 2.608-10.355, < 0.001) and increased aortic root (OR 2.115, 95% CI 1.144-3.912, = 0.017) were significantly associated with catheter change. Mediastinal-cardiac ratio and aortic root diameter provide helpful and effective indices for appropriate catheter selection during transradial coronary angiography.
在进行经桡动脉冠状动脉造影（CAG）时，选择合适的导管有助于缩短检查时间，预防血管并发症并降低医疗费用。然而，在几乎所有情况下，导管的选择都是基于医生的经验。因此，我们进行了这项研究，以确定能够使医生预测合适导管选择的影像学和超声心动图指标。
这是一项回顾性研究，纳入了 2006 年 2 月至 2014 年 4 月在一家既定中心接受经桡动脉诊断性 CAG 的 244 例患者。成功使用 JL3.5 导管进行血管造影的患者被定义为对照组，而成功更换为 JL4.0 或更高型号导管后进行血管造影的患者被定义为更换组。为了确定合适导管选择的预测因素，分析了影像学和超声心动图指标。
在这项研究中，共分析了更换组的 122 例患者和对照组的 122 例患者。平均年龄为 64.65 ± 8.6 岁。在影像学指标方面，更换组的纵隔/胸廓比显著更高（0.27 ± 0.05 比 0.23 ± 0.03， < 0.001）。此外，更换组的纵隔/心脏比也显著更大（0.50 ± 0.08 比 0.45 ± 0.05， < 0.001）。主动脉根部直径（这里用作超声心动图指标）在更换组中明显大于对照组（34.94 ± 4.18 mm 比 32.66 ± 3.99 mm， < 0.001）。在多变量逻辑回归模型中，纵隔/心脏比（OR 5.197，95%CI 2.608-10.355， < 0.001）和主动脉根部增大（OR 2.115，95%CI 1.144-3.912， = 0.017）与导管更换显著相关。
纵隔/心脏比和主动脉根部直径为经桡动脉冠状动脉造影时选择合适的导管提供了有用且有效的指标。
