术前超声在经桡动脉远心端途径冠状动脉介入治疗的疗效和安全性中的重要作用。
The important role of preoperative ultrasound in the efficacy and safety of coronary intervention via distal transradial access.
作者信息
Chen Tao, Li Lamei, Yang Anni, Fan Xinyu, Shi Ganwei, Li Feng, Cai Gaojun
机构信息
Department of Cardiology, The First Affiliated Hospital Of Ningbo University, Ningbo City, 315000, Zhejiang Province, China.
Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, the Wujin Clinical College of Xuzhou Medical University, Changzhou City, 213017, Jiangsu Province, China.
出版信息
BMC Cardiovasc Disord. 2025 May 26;25(1):404. doi: 10.1186/s12872-025-04861-y.
BACKGROUND
The optimal inner diameter for enhancing the success rate of distal radial artery (DRA) puncture has not been documented. The aim of this study was to explore the appropriate inner diameter of DRA to increase the success rate of puncture and reduce vascular complications.
METHODS
This is a retrospective study. A receiver operating characteristic (ROC) curve was plotted to predict the DRA inner diameter for puncture success. The operative efficacy and safety were compared between groups with different DRA inner diameters, grouped according to the cut-off value.
RESULTS
A total of 670 patients were included in the study. The DRA inner diameter had a significant predictive value (AUC = 0.718) for puncture success, with a cut-off value of 1.95 mm. The puncture success rate was significantly lower in the DRA inner diameter < 2.0 mm group than in the DRA inner diameter ≥ 2.0 mm group (93.1% vs. 98.2%, P = 0.001). Twenty-five (3.7%) developed distal radial artery occlusion (dRAO) after the operation, including 15 dRAO without proximal radial artery occlusion (pRAO) and 10 dRAO with pRAO. The incidence of dRAO with pRAO was significantly greater in the DRA inner diameter < 2.0 mm subgroup than in the DRA inner diameter ≥ 2.0 mm subgroup (2.8% vs. 0.5%, P = 0.041).
CONCLUSIONS
The success rate of puncture was lower in patients with DRA inner diameter < 2.0 mm, whereas the incidence of dRAO with pRAO was higher.
CLINICAL TRIAL NUMBER
Not applicable.
背景
目前尚无关于提高桡动脉远端（DRA）穿刺成功率的最佳内径的文献报道。本研究旨在探讨合适的DRA内径，以提高穿刺成功率并减少血管并发症。
方法
这是一项回顾性研究。绘制受试者工作特征（ROC）曲线以预测穿刺成功的DRA内径。根据截断值将不同DRA内径的组进行比较，对比手术疗效和安全性。
结果
本研究共纳入670例患者。DRA内径对穿刺成功具有显著预测价值（AUC = 0.718），截断值为1.95毫米。DRA内径<2.0毫米组的穿刺成功率显著低于DRA内径≥2.0毫米组（93.1%对98.2%，P = 0.001）。术后25例（3.7%）发生桡动脉远端闭塞（dRAO），其中15例dRAO无桡动脉近端闭塞（pRAO），10例dRAO伴有pRAO。DRA内径<2.0毫米亚组中伴有pRAO的dRAO发生率显著高于DRA内径≥2.0毫米亚组（2.8%对0.5%，P = 0.041）。
结论
DRA内径<2.0毫米的患者穿刺成功率较低，而伴有pRAO的dRAO发生率较高。
临床试验编号
不适用。
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