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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.

DOI:10.1186/s12872-025-04861-y
PMID:40419945
Abstract

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.

摘要

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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本文引用的文献

1
Application of ultrasound in cardiovascular intervention the distal radial artery approach: New wine in old bottles?超声在心血管介入中的应用——桡动脉远端入路:旧瓶装新酒?
Front Cardiovasc Med. 2022 Dec 15;9:1019053. doi: 10.3389/fcvm.2022.1019053. eCollection 2022.
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International Hand Function Study Following Distal Radial Access: The RATATOUILLE Study.国际桡动脉入路后手功能研究:RATATOUILLE 研究。
JACC Cardiovasc Interv. 2022 Jun 27;15(12):1205-1215. doi: 10.1016/j.jcin.2022.04.023. Epub 2022 May 17.
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Analysis of the Risk Factors Related to the Success Rate of Distal Transradial Artery Access in Patients with Coronary Heart Disease.
冠心病患者桡动脉远端穿刺成功率相关危险因素分析
Risk Manag Healthc Policy. 2022 Apr 13;15:657-663. doi: 10.2147/RMHP.S357780. eCollection 2022.
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Safety and Feasibility of Ultrasound-Guided Access for Coronary Interventions through Distal Left Radial Route.经远端左侧桡动脉入路行冠状动脉介入治疗的安全性及可行性。
J Interv Cardiol. 2022 Mar 25;2022:2141524. doi: 10.1155/2022/2141524. eCollection 2022.
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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.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。
BMC Cardiovasc Disord. 2022 Mar 2;22(1):74. doi: 10.1186/s12872-022-02518-8.
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Factors influencing radial artery occlusion after transradial coronary intervention in the Indian population.印度人群行经桡动脉冠状动脉介入治疗后桡动脉闭塞的影响因素。
Anatol J Cardiol. 2022 Feb;26(2):105-111. doi: 10.5152/AnatolJCardiol.2021.163.
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Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment.基于超声评估的桡动脉远端参考直径及特征。
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Distal or Traditional Transradial Access Site for Coronary Procedures: A Single-Center, Randomized Study.经远端桡动脉或传统桡动脉入路行冠状动脉介入治疗:一项单中心、随机研究。
JACC Cardiovasc Interv. 2022 Jan 10;15(1):22-32. doi: 10.1016/j.jcin.2021.09.037. Epub 2021 Dec 15.
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The learning curve of the distal radial access for coronary intervention.经桡动脉入路行冠状动脉介入治疗的学习曲线。
Sci Rep. 2021 Jun 24;11(1):13217. doi: 10.1038/s41598-021-92742-7.
10
Distal Radial Access: Consensus Report of the First Korea-Europe Transradial Intervention Meeting.经桡动脉入路:第一届韩-欧经桡动脉介入治疗会议共识报告。
JACC Cardiovasc Interv. 2021 Apr 26;14(8):892-906. doi: 10.1016/j.jcin.2021.02.033.