急性冠脉综合征左右冠状动脉病变患者应用单根MAC指引导管经桡动脉途径行经皮冠状动脉介入治疗的可行性研究

目的探讨急性冠脉综合征(ACS)左右冠状动脉病变患者应用单根MAC指引导管经桡动脉途径行经皮冠状动脉介入治疗(PCI)的可行性。方法选择我院2012年1月—2013年6月收治的ACS患者60例,根据随机序号分为观察组和对照组,每组30例。观察组患者采用单根6F MAC指引导管经桡动脉途径行PCI,对照组患者采用不同指引导管经桡动脉途径行PCI。观察两组患者桡动脉穿刺成功率、PCI成功率、造影剂用量、PCI操作时间、放射剂量、透视时间、介入治疗血管支数、平均支架数、血管并发症情况及出院后30 d主要心脏不良事件(MACE)发生情况等。结果两组患者桡动脉穿刺成功率均为100%,PCI成功率均为96.67%。两组患者造影剂用量、介入治疗血管支数、平均支架数及血管并发症发生率比较,差异均无统计学意义(P0.05)。观察组患者PCI操作时间、透视时间短于对照组,放射剂量小于对照组(P0.05)。两组患者出院后30 d均未出现MACE。结论 ACS左右冠状动脉病变患者应用单根MAC指引导管经桡动脉途径行PCI是可行的。

Feasibility of Single MAC Guiding Catheter in Acute Coronary Syndrome Patients with Left and Right Coronary Artery Lesion Treated by PCI through Transradial Approach

Objective To investigate the feasibility of single MAC guiding catheter in acute coronary syndrome（ACS） patients with left and right coronary artery lesion treated by PCI through transradial approach. Methods From January2012 to June 2013,60 patients with ACS were selected,and then they were divided into observation group and control group according to random number,30 cases in each. Observation group given PCI through transradial approach using single 6F MAC guiding catheter,control group given PCI through transradial approach using different guiding catheters. Success rate of puncture,success rate of PCI,usage of contrast media,PCI operation time,radiation dose,X- ray exposed time,treated vessel counts,mean stent counts,incidence of vascular complications and MACE 30 days after discharge were observed. Results The success rates of puncture of both groups were 100%,and the success rates of PCI of both groups were 96. 67%. There was no significant difference of usage of contrast media,treated vessel counts,mean stent counts and incidence of vascular complications between the two groups（P〉0. 05）; the PCI operation time and X- ray exposed time were shorter,radiation dose was less of observation group than those of control group（P〈0. 05）. No one of the two groups occurred MACE 30 days after discharge. Conclusion It is feasible of single MAC guiding catheter in ACS patients with left and right coronary artery lesion treated by PCI through transradial approach.