经桡动脉行冠状动脉慢性完全闭塞病变介入治疗28例临床分析

目的评价经桡动脉行冠状动脉慢性完全闭塞病变(CTO)介入治疗的疗效及安全性。方法对2005年3月至2008年5月经桡动脉实施经皮冠状动脉介入(PCI)治疗的28例CTO患者的临床资料、病变特征和PCI结果进行回顾性分析。CTO靶血管共28支,平均闭塞时间为(8.7±4.2)个月,按Seldinger法穿刺右桡动脉后置入6F桡动脉鞘,之后再按标准方法行球囊扩张及支架置入术。结果24例患者成功完成了冠脉内支架植入术,共植入药物洗脱支架25枚。成功率为85.7%(24/28),与我院同期经股动脉途径PCI治疗的31例CTO病例相似,差异无统计学意义(P<0.05)。75%(3/4)的失败病例均是由于导丝无法通过闭塞段所致。所有病例住院期间均未发生主要不良心脏事件。结论经桡动脉途径PCI治疗CTO安全可行,成功率并不低于经股动脉途径,不失为一个较理想的介入治疗途径。

Transradial Coronary Intervention in 28 Patients with Chronic Total Coronary Occlusion

Objective To assess the technique and outcomes of transradial coronary intervention in patients with chronic total occlusion （CTO）. Methods Clinical datas, lesion characteristics and procedural success rates of the 28 patients with CTO who were treated by transradial coronary interven- tion between March 2006 and May 2007 were retrospectively analyzed. There were 28 CTO lesions in 28 vessels with a mean occlusion time of（ 8.7 ＋ 4.2） months. Results Total success rate of patients and lesions was 85.7% （24/28）, comparable with the 31 CTO lesions performed using standard femoral ap- proach at the same time,while a total of 25 Drug-eluting stents were implanted to those target lesions. The most common cause of failure（75% ）was an inability to pass the lesion a guidewire. There was no in-hospital major adverse cardiac events（MACE） occurred after PCI for CTO. Conclusion The radial artery might be a feasible vascular route in coronary interventions for CTO ,with comparable procedural success and no access site complications.