经桡动脉途径行冠状动脉介入操作69例临床分析

目的：探讨国人经桡动脉行冠状动脉介入检查、治疗的可行性和安全性。方法：选择2001年4月至2003年5月间住院拟行冠状动脉造影检查的适宜患者69例。结果：5例穿刺未成功(5／69，占7．2％)；因右锁骨下动脉扭曲而造影失败1例，造影成功率为98．4％(63／64)；10例接受IVUS；行切割球囊冠脉成形术17例，3例随后植入了支架；6例因支架内再狭窄而行血管内放射治疗。28例行PTCAV支架术，共植入支架32枚，其中1例PTCA未成功，手术成功率96．4％(27／28)。有2例患者用8F鞘，术中疼痛明显，5例术后局部轻度淤血。出院时所有患者的桡动脉搏动良好。术后3个月内未发生严重不良事件。4例随访时桡动脉搏动明显减弱或消失，但无手部缺血或功能障碍。结论：经桡动脉介入治疗局部并发症少，不影响抗凝药物的使用，但对术者技术要求较高。

Clinical analysis of percutaneous radial artery approach for coronary intervention in 69 patients

Objective To explore the safety and feasibility of percutaneous radial artery approach for coronary intervention. Methods From April 2001 to May 2003, a total of 69 patients underwent transradial coronary intervention and at least 3-month clinical follow-up. Results Successful cannulation was achieved in 92.8% of patients. Angiogram was successful in 63 patients (98.4%), only one failure. 10 patients underwent intravascular ultrasound. Cutting balloon angioplasty was done in 17 cases, 3 of them with coronary stenting. 6 patients with in-stent restenosis were treat with transradial brachytherapy. The two patients used 8 F sheath suffered from a severe pain during the procedure. Plain balloon angioplasty and intracoronary stenting were successfully done in 27 patients with one failure (96.4%). Thirty-two stents were successfully deployed (100%) and there were no major adverse coronary events (MACE) within 24 hours and at 3 months. The pulsation of right radial artery was attenuated or disappeared in 4 patients during follow-up, though it did no harm to the hand function. Conclusion In transradial artery approach, there was fewer complications after PCI, and it has no effect on the use of anticoagulation drugs. However, the operator should have been skillful.