无肝素冠状动脉造影术1400例临床分析

Clinical analysis of 1400 cases of coronary artery angiography without heparin

OBJECTIVE: To evaluate the feasibility and safety of coronary artery angiography via femoral artery approach without heparin. METHODS: Totally 1 400 consecutive patients undergoing coronary artery angiography with heparin were analyzed retrospectively in comparison with the data of 354 patients for coronary artery angiography without heparin. RESULTS: Success in selective coronary artery angiography was achieved in 99.3% of the patients in the non-heparin group, with the mean operation time of 17.9+/-11.3 min ranging from 8 min to 1 hour. Angiography identified coronary artery stenosis in 72.2% of the patients including 49.8% with multivessel involvement. Subcutaneous hematoma occurred in 25 (1.8%) of the patients, and 1 (0.07%) patient developed arterial and venous fistula and pseudoaneurysm at the puncture site, but other complications (retroperitoneal hematoma, acute myocardial infarction, stroke and peripheral artery thrombotic events) occurred neither during nor after the procedure. In the heparin group, 18 (5.1%) patients developed subcutaneous hematoma and 1 (0.2%) had arterial and venous fistula and pseudoaneurysm at the puncture site after angiography. CONCLUSION: Coronary artery angiography without heparin is both safe and feasible with only very low risk of complications.