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接受经皮冠状动脉介入治疗患者桡动脉闭塞的发生率及预测因素

Frequency and Predictors of Radial Artery Occlusion in Patients Undergoing Percutaneous Coronary Intervention.

作者信息

Munir Ussama, Khan Rozi, Nazeer Nouman, Akhter Junaid, Hassan Anwaar Ul, Hanif Bashir

机构信息

Cardiology, Bahawal Victoria Hospital, Bahawalpur, PAK.

Internal Medicine, Bolan University of Medical and Health Sciences, Quetta, PAK.

出版信息

Cureus. 2022 May 30;14(5):e25505. doi: 10.7759/cureus.25505. eCollection 2022 May.

Abstract

Background and objective Transradial access (TRA) has become the preferred route for percutaneous coronary interventions (PCI), and this site is often a chink in the armor for staged PCI. In this study, we aimed to evaluate the incidence and predictors of radial artery occlusion (RAO) after TRA. Methods We conducted a retrospective study involving 1,307 patients who underwent PCI at the Tabba Heart Institute (THI) in Karachi, Pakistan from August 2018 to June 2019. TR band was used for hemostasis after PCI. Results The primary outcome of our study was RAO, which was observed in 11.3% of the study subjects. On multivariate analysis, female gender [odds ratio (OR): 1.79, 95% CI: 1.21-2.64], cardiovascular instability (OR: 2.5, 95% CI: 1.22-5.11), dyslipidemia (OR: 0.61, 95% CI: 0.4-0.92), and a higher number of diseased vessels were found to be predictors of RAO (p=0.004). Conclusion RAO is often an asymptomatic complication of TRA. To ensure radial artery patency, a carefully thought-out management plan and follow-up must be devised for high-risk patients.

摘要

背景与目的 经桡动脉途径(TRA)已成为经皮冠状动脉介入治疗(PCI)的首选途径,而该部位在分期PCI中往往是一个薄弱环节。在本研究中,我们旨在评估TRA后桡动脉闭塞(RAO)的发生率及预测因素。方法 我们进行了一项回顾性研究,纳入了2018年8月至2019年6月在巴基斯坦卡拉奇塔巴心脏研究所(THI)接受PCI的1307例患者。PCI术后采用TR带进行止血。结果 我们研究的主要结局是RAO,在11.3%的研究对象中观察到。多因素分析显示,女性[比值比(OR):1.79,95%置信区间(CI):1.21 - 2.64]、心血管不稳定(OR:2.5,95% CI:1.22 - 5.11)、血脂异常(OR:0.61,95% CI:0.4 - 0.92)以及病变血管数量较多是RAO的预测因素(p = 0.004)。结论 RAO通常是TRA的无症状并发症。为确保桡动脉通畅,必须为高危患者制定精心考虑的管理计划和随访方案。

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