经桡动脉介入治疗急性心肌梗死伴心源性休克的临床应用

目的探讨经桡动脉冠状动脉介入治疗(PCI)合并心源性休克(CS)的急性ST段抬高心肌梗死(STEMI)的安全性和有效性。方法 STEMI伴CS患者48例中,21例经桡动脉急诊PCI(TRA组),27例经股动脉急诊PCI(TFA组)。所有患者应用主动脉内气囊反搏术(IABP)和盐酸替罗非班,观察手术情况及预后。结果两组穿刺成功率、PCI成功率、穿刺至首次球囊扩张时间、手术时间、血管并发症、住院期间及6个月主要不良心脏事件均无统计学意义的差异(P>0.05)。结论急诊经桡动脉PCI在伴CS的STEMI患者与股动脉途径PCI一样安全有效。对IABP安置后行PCI的患者,桡动脉途径是很好的替代途径。

Clinical application of transradial percutaneous coronary intervention for acute myocardial infarction with cardiogenic shock

Objective To observe the safety and efficacy of transradial percutaneous coronary intervention(PCI) for acute ST elevation myocardial infarction(STEMI) with cardiogenic shock(CS).Methods A total of 48 patients with STEMI with CS was treated by PCI via radial arterial approach(group TRA,21 cases) and PCI via femoral arterial approach(group TFA,27 cases).Intraarterial balloon counter-pulsation(IABP) and tirofiban were used in all patients.The procedure and major adverse cardiac events(MACE) were compared.Results The success rates of puncture and procedure,the time of puncture to first balloon-inflation,the procedure time,the vascular complication,and the MACE during hospital stay and the period of six months follow-up in two groups were all similar(P>0.05).Conclusion PCI via radial arterial approach is as efficient as that via transfemoral approach in the patients with STEMI with CS,which can be taken as an alternative way to PCI after IABP.