Lotan C, Hasin Y, Mosseri M, Rozenman Y, Admon D, Nassar H, Gotsman M S
Department of Cardiology, Hadassah University Hospital, Jerusalem, Israel.
Am J Cardiol. 1995 Jul 15;76(3):164-7. doi: 10.1016/s0002-9149(99)80050-2.
The transradial approach has currently been advocated as an alternative catheterization method for coronary angiography and angioplasty, due to the recent miniaturization of angioplasty equipment. The purpose of this study was to assess the practical clinical applicability of this method. From June to November 1994, 100 patients underwent coronary angiography and angioplasty with the transradial approach. Their mean age was 66.6 +/- 11.2 years, and 79 were men. In 4, radial puncture was not successful, and in 3, femoral access was necessary to complete the procedure. Coronary angioplasty was performed in 63 patients (76 lesions) with angiographic success (per lesion) of 96%. In 5 patients, a stent was successfully implanted. All patients were ambulatory on the day after the angioplasty procedure. In 98% of the patients, the introducer was taken out 1 to 4 hours after the procedure by local compression using a special custom-made device. No patient required blood transfusion. Major complications occurred in 2 patients; both had a cerebrovascular accident (1 probably not procedure-related), and both recovered. A radial pulse was palpated in 91 of the patients before discharge, and in 6 others, adequate flow could be heard with Doppler. In 2 patients, radial flow was restored within several weeks. None of the patients suffered from ischemia of the hand. Two patients had a small pseudoaneurysm successfully treated by local compression. Thus, coronary angioplasty can be performed safely using the transradial approach with relatively few vascular complications and with better patient comfort. However, the procedure is more time-consuming initially compared with the transfemoral approach due to a learning curve regarding equipment selection and catheter manipulation.
由于近期血管成形术设备的小型化，经桡动脉途径目前已被提倡作为冠状动脉造影和血管成形术的一种替代导管插入方法。本研究的目的是评估该方法的实际临床适用性。1994年6月至11月，100例患者接受了经桡动脉途径的冠状动脉造影和血管成形术。他们的平均年龄为66.6±11.2岁，男性79例。4例桡动脉穿刺未成功，3例需要股动脉入路以完成手术。63例患者（76处病变）进行了冠状动脉血管成形术，血管造影成功率（每处病变）为96%。5例患者成功植入了支架。所有患者在血管成形术后次日即可下床活动。98%的患者在术后1至4小时通过使用特殊定制装置进行局部压迫取出了导管鞘。无患者需要输血。2例患者发生了主要并发症；均发生了脑血管意外（1例可能与手术无关），且均康复。91例患者出院前可触及桡动脉搏动，另外6例通过多普勒可听到充足的血流声。2例患者的桡动脉血流在数周内恢复。无患者发生手部缺血。2例患者有小的假性动脉瘤，通过局部压迫成功治疗。因此，使用经桡动脉途径进行冠状动脉血管成形术可以安全地进行，血管并发症相对较少，患者舒适度更高。然而，由于在设备选择和导管操作方面存在学习曲线，与经股动脉途径相比，该手术最初耗时更长。
