经桡动脉冠状动脉介入治疗高危冠心病患者的临床研究

目的:评价经桡动脉途径行冠状动脉介入治疗高危冠心病患者临床疗效及安全性。方法:经桡动脉途径对385例冠心病患者行冠状动脉介入治疗,观察其临床疗效及血管并发症。结果:对385例562支冠状动脉病变内置入1179枚支架,其中置入前降支664枚,右冠状动脉397枚,回旋支102枚,左主干16枚,置入支架直径为2.25mm～4.0mm,长度为8mm～36mm。置入后经冠状动脉造影证实狭窄消失,即刻效果良好,由术前狭窄(88.7±8.6)%减至术后残余狭窄(6.8±4.7)%,支架置入成功率97.9%。9例出现桡动脉闭塞,7例出现血肿,5例术后出现前臂疼痛,无神经损伤,死亡1例。结论:经桡动脉途径进行冠状动脉介入治疗高危冠心病患者损伤小,血管并发症少,对高危冠心病患者是一种安全、有效的介入治疗方法。

Clinical research of transradial approach for percutaneous coronary intervention of high-risk patients with coronary heart disease

Objective:To evaluate the safety and clinical effect of transradial approach for percutaneous coronary intervention of high-risk patients with coronary heart disease.Methods:385 patients with coronary heart disease received transradial approach for percutaneous coronary intervention in which the clinical effect and vascular complications were observed.Results:For 562 coronary artery lesions of 385 patients with coronary heart disease,1179 stents were implanted in which 664 were implanted in anterior descending branches,397 in right coronary arteries,102 in circumflex arteries and 16 in left main coronary arteries.These stents were 2.25mm～4.0mm in diameter and 8mm～36mm in length.Immediately postoperative coronary angiography showed satisfactory effects in which stenosis lesions disappeared.The preoperative stenosis of(88.7±8.6)% decreased to residual stenosis of(6.8±4.7)% after intervention,and the success rate of implantation was 97.9%.In terms of complications,9 cases developed radial artery occlusion,7 cases developed hematoma,5 cases developed forearm ache without nerve injury and 1 case was death.Conclusion:Transradial approach for percutaneous coronary intervention is a safe and effective treatment for high-risk patients with coronary heart disease due to its slight injury and less vascular complications.