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一项新型肘关节固定装置在经肱动脉行冠状动脉诊断或治疗术患者中应用的随机研究:术后并发症

Randomized study for a novel elbow joint fixation device on postoperative complications in patients undergoing percutaneous coronary diagnostic or therapeutic procedures through the brachial artery.

机构信息

Chengdu Medical College, Chengdu, Sichuan, China.

The Sixth People's Hospital of Deyang City, Deyang, Sichuan, China.

出版信息

Sci Rep. 2024 Sep 4;14(1):20535. doi: 10.1038/s41598-024-71241-5.

Abstract

Brachial artery access for coronary diagnostic or therapeutic procedures is associated with a greater risk of vascular complications. To determine whether 3D printing of a novel elbow joint fixation device could reduce postoperative complications after percutaneous coronary diagnostic or therapeutic procedures through the brachial artery. Patients who underwent percutaneous coronary diagnostic or therapeutic procedures by brachial access were randomly assigned to receive either a 3D-printed elbow joint fixation device (brace group) or traditional compression (control group) from March 2023 to December 2023. The severity of puncture site-related discomfort at 24 h postsurgery was significantly lower in the brace group (P = 0.014). Similarly, the upper arm calibration rate at 24 h postsurgery was significantly lower in the brace group [0.024 (0.019-0.046) vs. 0.077 (0.038-0.103), P < 0.001], as was the forearm calibration rate [0.026 (0.024-0.049) vs. 0.050 (0.023-0.091), P = 0.007]. The brace group had a significantly lower area of subcutaneous hemorrhage at 24 h postsurgery [0.255 (0-1.00) vs. 1 (0.25-1.75) cm]. In patients who underwent percutaneous coronary diagnostic or therapeutic procedures by brachial access after manual compression hemostasis, the novel elbow joint fixation device was effective at reducing puncture site-related discomfort, alleviating the degree of swelling, and minimizing the subcutaneous bleeding area. Additionally, no significant complications were observed.Trial registration: China Clinical Trial Registration on 01/03/2023 (ChiCTR2300068791).

摘要

经肱动脉入路行冠状动脉诊断或治疗性操作与血管并发症风险增加相关。本研究旨在确定新型肘关节固定装置的 3D 打印是否可以降低经肱动脉行冠状动脉诊断或治疗性操作后的术后并发症。2023 年 3 月至 2023 年 12 月,将接受经肱动脉入路行冠状动脉诊断或治疗性操作的患者随机分为 3D 打印肘关节固定装置(支具组)或传统压迫(对照组)组。术后 24 小时,支具组穿刺部位相关不适的严重程度明显低于对照组(P=0.014)。同样,支具组术后 24 小时上臂标定率[0.024(0.019-0.046)比 0.077(0.038-0.103),P<0.001]和前臂标定率[0.026(0.024-0.049)比 0.050(0.023-0.091),P=0.007]也明显更低。术后 24 小时,支具组的皮下血肿面积明显更小[0.255(0-1.00)比 1(0.25-1.75)cm]。在接受手动压迫止血后经肱动脉入路行冠状动脉诊断或治疗性操作的患者中,新型肘关节固定装置可有效减轻穿刺部位相关不适,缓解肿胀程度,最大限度减少皮下出血面积。此外,未观察到明显并发症。试验注册:中国临床试验注册中心,ChiCTR2300068791,2023 年 1 月 3 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4c4/11375105/c63b4ef6b8c1/41598_2024_71241_Fig1_HTML.jpg

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