经桡动脉与经股动脉两种途径冠心病介入治疗的对比研究

目的 :比较经桡动脉途径和股动脉途径冠心病介入的手术方法、结果和并发症。方法 :10 3 3例冠心病住院患者分别接受经桡动脉 （ A）组 （ n=419）或经股动脉 （ F）组 （ n=614 ）途径的冠心病介入 （ PCI）治疗 ,观察两组手术成功率和并发症发生率。结果 :两组患者 PCI成功率没有显著性差异。A组局部血肿、不适反应等发生率显著低于 F组 ,假性动脉瘤、动静脉瘘、局部感染及表皮坏死等并发症在 A组未出现 ,F组分别发生 11,4,6,7例 ,但两组间无显著性差异。两组均未出现远端肢体缺血、神经损伤等。结论 :实施 PCI术的两种途径都是安全、有效和可行的方法 ,与经股动脉比较 ,经桡动脉途径可减少并发症的发生

A comparison of percutaneous transluminal coronary intervention by radial and femoral approaches

AIM: To compare the radial approach with the femoral approach for coronary intervention in patients with coronary heart disease. METHODS: During 11 months, we performed consecutive coronary angiographies and angioplasties in 419 patients via radial artery with percutaneous approach (Group A) and in 614 patients via femoral artery(Group F). Exclusion criteria for transradial approach were the absence of radial pulse and abnormal Allen's test. Major complications in the two groups were recorded. RESULTS:The success rate was 98.6 % (413/419) in Group A and 98.3 % (603/614) in Group F( P >0.05). Minor hematoma occurred in 7 patients with transradial approach and in 72 with transfemoral approach(1.7 % vs 11.7 %, P <0 01). Major hematoma complications occurred in 2 patients in Group A and 16 patient in Group F(0.5 % vs 2.6 %, P <0.05), In Group A, 1 patient lost radial pulse during the 30 day follow up period. But none of the patients suffered pseudoaneurysm, arteriovenous fistula, and ischemia of the hand. CONCLUSION: Coronary intervention via the transradial approach is a safe and feasible alternative to the conventional transfemoral approach, with relatively fewer vascular complications and more comfort for the patient.