桡动脉闭塞的逆行再通：经桡动脉远端途径：单中心经验
Retrograde recanalization of radial artery occlusion the distal transradial artery: A single-center experience.
作者信息
Lin Yaowang, Bei Weijie, Liu Huadong, Liu Qiyun, Yuan Jie, Wu Meishan, Sun Xin, Dong Shaohong
机构信息
Department of Cardiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen Key Medical Discipline, Shenzhen, China.
出版信息
Front Cardiovasc Med. 2022 Sep 23;9:985092. doi: 10.3389/fcvm.2022.985092. eCollection 2022.
BACKGROUND
Radial artery occlusion (RAO) often occurs after catheterization when using a transradial artery approach.
OBJECTIVE
This prospective study assessed the success and feasibility of accessing the distal transradial artery (dTRA) for retrograde recanalization of RAO.
METHODS
From June 2019 to December 2021, 44 consecutive patients who had undergone cardiac catheterization resulting in RAO were given retrograde recanalization via the dTRA. According to the result of the procedure (primary endpoint), patients' cases were analyzed as successful or failed. Rates of post-operative patency and adverse events were calculated up to 12 months.
RESULTS
The procedural success rate was 88.6%. Compared with the successful group, a significantly higher percentage of patients in the failed group were current smokers and/or suffered from diabetes mellitus (each, 80.0% cf. 33.3%, = 0.046); had undergone at least 3 previous cardiac catheterizations (60.0% cf. 12.8%, = 0.011), lower rate of anticoagulation (30.77% cf. 0%, = 0.048) and exhibited chronic total occlusion (100.0% cf. 51.28%, = 0.041). In each group, one patient each had minor bleeding at the access site and hematoma. The patency rates in the successful group at postoperative 3, 6, and 12 months were 48.7, 43.6, and 35.9%, respectively.
CONCLUSION
The dTRA approach for retrograde recanalization of RAO showed a high procedural success rate, but with patency rates of <50% at follow-up.
背景
采用经桡动脉途径进行导管插入术后常发生桡动脉闭塞（RAO）。
目的
本前瞻性研究评估经桡动脉远心端（dTRA）逆行开通RAO的成功率及可行性。
方法
2019年6月至2021年12月，44例因心脏导管插入术导致RAO的连续患者经dTRA进行逆行开通。根据手术结果（主要终点），将患者病例分析为成功或失败。计算术后12个月内的通畅率及不良事件发生率。
结果
手术成功率为88.6%。与成功组相比，失败组中当前吸烟者和/或患有糖尿病的患者比例显著更高（分别为80.0% 对比33.3%，P = 0.046）；既往至少接受过3次心脏导管插入术的患者比例更高（60.0% 对比12.8%，P = 0.011），抗凝率更低（30.77% 对比0%，P = 0.048），且慢性完全闭塞的比例更高（100.0% 对比51.28%，P = 0.041）。每组各有1例患者在穿刺部位出现轻微出血和血肿。成功组术后3个月、6个月和12个月的通畅率分别为48.7%、43.6%和35.9%。
结论
采用dTRA途径逆行开通RAO显示出较高的手术成功率，但随访时通畅率<50%。
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