Spaulding C, Lefèvre T, Funck F, Thébault B, Chauveau M, Ben Hamda K, Chalet Y, Monségu H, Tsocanakis O, Py A, Guillard N, Weber S
Cardiology Department, Cochin Hospital, René Descartes University, Paris, France.
Cathet Cardiovasc Diagn. 1996 Dec;39(4):365-70. doi: 10.1002/(SICI)1097-0304(199612)39:4<365::AID-CCD8>3.0.CO;2-B.
Although radial approach has been shown to be feasible for coronary angiography, angioplasty, and even stent placement, there have been no prospective evaluations of ease and safety of left radial approach for coronary angiogram. We examined procedural duration and success as well as complications in 415 consecutive patients. Radial artery occlusion was assessed immediately post-procedure and at 2 month follow-up using echo-Doppler measurements. Procedure failure rate was 9%, mean time for sheath insertion was 4.7 +/- 4.7 min, and mean procedure duration was 19.1 +/- 8.2 min. No major complications occurred. Asymptomatic radial artery occlusion was noted in 71% of the first 49 patients, decreased to 24% in the next 119 receiving 2,000-3,000 units of heparin, and to 4.3% in the last 210 receiving 5000 (p < 0.05). Comparison with the femoral approach in the same laboratory suggested that the radial approach took longer, but provided similarly high-quality results without great difficulty in coronary cannulation. Hence, the left radial approach for coronary angiography (with heparin administration) allows immediate ambulation and may be especially useful for outpatients and when the femoral approach is not possible.
尽管桡动脉途径已被证明可用于冠状动脉造影、血管成形术甚至支架置入，但对于冠状动脉造影的左桡动脉途径的便捷性和安全性尚无前瞻性评估。我们检查了415例连续患者的手术时间、成功率及并发症。术后即刻及2个月随访时使用超声多普勒测量评估桡动脉闭塞情况。手术失败率为9%，鞘管插入平均时间为4.7±4.7分钟，平均手术时间为19.1±8.2分钟。未发生重大并发症。在前49例患者中，71%出现无症状桡动脉闭塞，在接下来接受2000 - 3000单位肝素治疗的119例患者中降至24%，在最后接受5000单位肝素治疗的210例患者中降至4.3%（p<0.05）。与同一实验室的股动脉途径比较表明，桡动脉途径耗时更长，但能提供同样高质量的结果，冠状动脉插管时也没有很大困难。因此，冠状动脉造影的左桡动脉途径（给予肝素）可让患者立即下床活动，对于门诊患者以及无法采用股动脉途径时可能特别有用。
