Petronio A S, Amoroso G, Limbruno U, Baglini R, Ciabatti N, Buttitta F, Balbarini A, Mariani M
Istituto di Cardiologia, Università degli Studi, Pisa.
Cardiologia. 1996 Oct;41(10):973-9.
The peripheral vascular complications following cardiac catheterization for interventional procedures are increasing. The aim of our study is to evaluate the importance of the early removal of the arterial sheath in reducing vascular complications. We examined 451 consecutive patients, submitted to percutaneous transluminal coronary angioplasty (PTCA) by femoral approach. In 229 patients (Group A), we removed the arterial sheath 12-14 hours after PTCA; in 222 patients (Group B) the arterial sheath was removed as soon as possible at the end of PTCA. In 31 Group A and 5 Group B patients we performed a coronarographic study after 12-14 hours. In total, 16 patients (11 Group A, 5 Group B) presented vascular complications. None of the risk factors that we have considered was predictive for complications, except that iliacofemoral atherosclerotic disease. In patients undergoing complex procedures we have found a greater amount of vascular complications. The coronarographic control revealed some pathologic lesion (dissection, occlusive thrombus) only in patients with clear ischemic signs or symptoms, both in Group A and B. In our opinion, an early removal of the arterial sheath reduces the incidence of vascular complications and the period of in-hospital stay.
介入性操作心脏导管插入术后的外周血管并发症正在增加。我们研究的目的是评估早期拔除动脉鞘在减少血管并发症方面的重要性。我们检查了451例连续通过股动脉途径接受经皮腔内冠状动脉成形术（PTCA）的患者。在229例患者（A组）中，我们在PTCA术后12 - 14小时拔除动脉鞘；在222例患者（B组）中，在PTCA结束后尽快拔除动脉鞘。在31例A组和5例B组患者中，我们在12 - 14小时后进行了冠状动脉造影研究。总共16例患者（11例A组，5例B组）出现了血管并发症。除髂股动脉粥样硬化疾病外，我们所考虑的危险因素均不能预测并发症。在接受复杂操作的患者中，我们发现血管并发症的发生率更高。冠状动脉造影检查仅在A组和B组中有明确缺血体征或症状的患者中发现了一些病理性病变（夹层、闭塞性血栓）。我们认为，早期拔除动脉鞘可降低血管并发症的发生率和住院时间。
