经皮桡动脉冠状动脉造影及冠状动脉成形术的临床应用

目的 :评价经皮桡动脉冠状动脉造影术与冠状动脉腔内成形术 (PTCA)的临床应用价值。方法 :有选择性的对 37例患者行经皮桡动脉途径冠状动脉造影及冠状动脉成形术 ,观察其疗效和血管并发症。结果 :1 桡动脉穿刺成功率为 93 8% (有 2例失败 )。 2 14例冠状动脉造影正常 ,17例冠状动脉造影显示 2 6处存在≥ 70 %的狭窄病变 ,适合行冠状动脉介入手术。 2 6处病变有 4处PTCA疗效满意 ,2 2处行PTCA +支架术 ,植入支架 31只。狭窄从 (81± 12 ) %降低至 (10 6± 7 4 ) % ,最小血管直径由 (0 86± 0 12 )mm增加至 (3 0 8± 0 32 )mm。 6例病人行冠状动脉旁路移植术。 3 所有患者术后即拔导管鞘 ,局部压迫 4h。术后并发症的发生率为 3 3% (1例术后的桡动脉闭塞 )。结论 :经桡动脉途径行冠状动脉造影及冠状动脉成形术安全可行 ,其具有穿刺部位出血少、住院时间短的特点 ,可选择性的应用于某些冠心病患者。

Transradial approach for coronary angiography and angioplasty

Objective:To evalate the clinical application of transradial approach for coronary angiography and angioplasty.Method:From september 2001 to october 2000,Coronary angiography and percutaneous coronary intervention(PCI)including PTCA and stent implantation in 31 selective patients with functional radial arch attested using Allen'test were performed with guiding catheter.Result:Radial arterial puncture was performed with success rate of 93.8%.31 patients were performed coronary angiography with 14 cases showing normal coronary artery and 17 cases showing ≥70% stenosis in 1 or/and more than 1 vessel of coronary arteries.PCI were performed in 17 cases with 26 lesions.4 lesions only done PTCA and 22 lesions were performed PTCA plus stent implantation.Diameter stenosis in (81±12)% was reduced to (10.6±7.4)% and mininum lumen diameter in (0.86±0.12)mm was increasd to (3 08±0.32)mm.Conclusion:Transradial approach for coronary angiography and angioplasty is safe and feasible and may represents a good alternative entry method in selected patients with low risk of complications and excellent procedural results. [