急性心肌梗塞经桡动脉腔内冠状动脉成形术

目的 近年来随着心导管器械的小型化,经桡动脉冠状动脉造影术及经皮腔内冠状动脉成形术(PTCA)已逐渐成为一种有益的替代途径.本文观察了其在急性心肌梗塞患者中的应用价值.方法和结果 对我院6例急性心肌梗塞患者行直接PT-CA,全部采用经桡动脉途径.其中男性4人,女性2人,平均年龄(62±5.8)岁.对6例梗塞相关血管行直接PTCA均获成功,其中4例各植入支架一枚.所有患者术后即拔导管鞘,局部弹性绷带固定、压迫4～6小时,无出血、假性动脉瘤、动静脉瘘等并发症发生.一例患者桡动脉搏动较术前减弱,无手缺血症状.结论 本研究初步显示,经桡动脉直接PTCA可安全有效应用于急性心肌梗塞患者.采用经桡动脉途径具有快速简便、穿刺中位出血并发症少、患者可尽早离床等优点.

Transradial approach for primary coronary angioplasty in patients with acute myocardial infarction

Objective Due to the recent miniaturization of angioplasty,the transradial approach has gained favour as an alternative catheterization method for coronary procedures. This study was to assess the practical clinical application of this method in patients with AMI. Methods Between June and August 1999,we attempted the transradial approach in 6 consective AMI patients with functional radial arch attested using Allen's test. Balloon angioplasty inclding stent implantation were performed with 6F guiding cathters. Results Radial punctures were performed in 6 patients with success rate of 100%. Angioplasty was attempted in the total study population,procedural success was achieved via the radial artery in all patients. Diameter stenosis was reduced from (95±4. 6)% to (12±8. 5)%. In 4 patients a cornary stent was implanted becaused PTCA results were suboptimal. The introducer was removed immediatedly after withdrawal of the guiding catheter and a pressure dressing over the puncture site was applied. Patients were ambulatory but were advised to restrict movements of the wrist. No major cardiac complications were encountered. No major site-related complicatins were observed and no patients required vascular surgery or blood transfusions. Conclusions Radial artery can be used as an access site for catheterization in selective patients with AMI. Transradial primary coronary angioplasty can be performed rapidly and successfully with elatively few vascular complications and with better patient comfort.