经桡动脉行冠状动脉介入治疗在老年冠心病患者中的应用

目的探讨老年冠心病患者经桡动脉行PCI的可行性和安全性。方泼选择709例老年(年龄≥75岁)冠心病患者,根据患者接受PCI的入路途径不同,分为桡动脉组(227例)和股动脉组(482例),比较两组患者临床基线PCI的成功率、造影剂用量、手术时间、并发症的发生率以及术后6个月时发生严重心脏不良事件的情况。结果桡动脉组血脂异常患者的比例高于股动脉组(P<0.05)。桡动脉组手术成功率为97.8%,股动脉组患者全部成功接受PCI。两组手术时间和造影剂用量比较,差异无统计学意义,桡动脉组3例(1.3%)患者出现血管并发症,股动脉组27例(5.6%)出现并发症,两组比较差异有统计学意义(P<0.05),桡动脉组和股动脉组患者术后6个月时严重心脏不良事件的发生率比较,差异无统计学意义(8.4% vs 7.3%,P>0.05)。结论老年冠心病患者经桡动脉行PCI具有良好的可行性和安全性。

The transradial approach for percutaneous coronary intervention in elderly patients

Objective To investigate the feasibility and safety of the percutaneous radial artery approach for angioplasty in elderly, patients. Methods 709 elderly patients(age≥75 yrs) who underwent PCI between October 2005 and July 2007 in Beijing Anzhen hospital were stndied. They were divided into 2 groups:227 patients were in transradial PCI(TRI) group and 482 patients in transfemoral PCI(TFI) group. The success rate of the procedure, the procedure time, the amount of contrast used and vascular complications between the two groups were compared. The end points were the incidence of MACE and stent thrombosis during 6-month follow-up. Results The procedure success rate was 97.8% in the TRI group. There were no significant differences in the mean procedure time (53.1±26.0) min vs (48.6±33.7) min] and amount of contrast used (135±41) ml vs (128±46) ml] between the two groups. Vascular complications occurred in 3 cases(1.3%) of TRI group and 27 cases(5.6%) of TFI group. During the 6-month follow-up, stent thrombosis occurred in 1 patient in each group and the incidences of MACE were similar in the two groups(8.4% vs 7.3%). Conclusion Transradial coronary intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of elderly patients.