经解剖鼻烟窝远端桡动脉入路行冠状动脉造影和经皮冠状动脉介入治疗的安全性和有效性：采用倾向评分法的单中心前瞻性队列研究。
Safety and efficacy of coronary angiography and percutaneous coronary intervention via distal transradial artery access in the anatomical snuffbox: a single-centre prospective cohort study using a propensity score method.
机构信息
Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, 2 North Yongning Road, Changzhou, 213017, Jiangsu Province, People's Republic of China.
Department of Ultrasonic, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China.
出版信息
BMC Cardiovasc Disord. 2022 Mar 2;22(1):74. doi: 10.1186/s12872-022-02518-8.
BACKGROUND
This study investigated the safety and efficacy of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via distal transradial artery access (d-TRA).
METHODS
For this single-centre prospective cohort study, a total of 1066 patients who underwent CAG or PCI procedures from September 2019 to November 2020 were included. Patients were divided into two groups: the d-TRA group (346) and the conventional transradial artery access (c-TRA) group (720) based on access site. A total of 342 pairs of patients were successfully matched using propensity score matching (PSM) for subsequent analysis.
RESULTS
No significant differences in puncture success rate, procedural method, procedural time, sheath size, contrast dosage or fluoroscopy time were noted between the two groups. The puncture time in the d-TRA group was longer than that in the c-TRA group (P < 0.01), and the procedure success rate was lower than that in the c-TRA group (90.94% vs. 96.49%, P = 0.01). The haemostasis time in the d-TRA group was shorter than that in the c-TRA group (P < 0.01), and the visual analogue scale (VAS) was lower than that in the c-TRA group (P < 0.01). In addition, the prevalence of bleeding and haematoma in the d-TRA group was lower than that in the c-TRA group (1.75% vs. 7.31%, P < 0.01; 0.58% vs. 3.22%, P = 0.01, respectively). No significant difference in the incidence of numbness was noted between the two groups. No other complications were found in two groups.
CONCLUSION
d-TRA is as safe and effective as c-TRA for CAG and PCI. It has the advantages of improved comfort and fewer complications. Trail registration Chinese Clinical Trial Registry, ChiCTR1900026519.
背景
本研究旨在探讨经远端桡动脉入路（d-TRA）行冠状动脉造影（CAG）和经皮冠状动脉介入治疗（PCI）的安全性和有效性。
方法
这是一项单中心前瞻性队列研究，共纳入 2019 年 9 月至 2020 年 11 月期间接受 CAG 或 PCI 治疗的 1066 例患者。根据入路将患者分为远端桡动脉入路组（d-TRA 组，346 例）和常规经桡动脉入路组（c-TRA 组，720 例）。采用倾向评分匹配（PSM）对 342 对患者进行成功匹配，用于后续分析。
结果
两组间穿刺成功率、手术方法、手术时间、鞘管大小、造影剂用量和透视时间无显著差异。d-TRA 组的穿刺时间长于 c-TRA 组（P<0.01），手术成功率低于 c-TRA 组（90.94% vs. 96.49%，P=0.01）。d-TRA 组的止血时间短于 c-TRA 组（P<0.01），视觉模拟评分（VAS）低于 c-TRA 组（P<0.01）。此外，d-TRA 组的出血和血肿发生率低于 c-TRA 组（1.75% vs. 7.31%，P<0.01；0.58% vs. 3.22%，P=0.01）。两组间麻木发生率无显著差异。两组均未发生其他并发症。
结论
d-TRA 用于 CAG 和 PCI 与 c-TRA 一样安全有效。它具有提高舒适度和减少并发症的优点。
试验注册
中国临床试验注册中心，ChiCTR1900026519。
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