无鞘7F普通导引导管经桡动脉介入治疗冠状动脉病变临床效果

目的 比较经桡动脉无鞘7F普通导引导管和常规6F鞘导引导管治疗冠状动脉病变的有效性和安全性.方法 回顾性分析2014年1月至2015年6月连续接受经皮冠状动脉介入治疗(PCI)手术的160例冠状动脉病变患者临床资料.随机分为无鞘组(n=80)和有鞘组(n=80),比较两种方法的导引导管到位、桡动脉创口压迫时间、止血成功、桡动脉痉挛、桡动脉术后血管直径、远端肿胀消退时间、前臂疼痛或不适、前臂血肿、假性动脉瘤、桡动脉闭塞、皮肤缺血坏死等.结果 无鞘组、有鞘组术中发生桡动脉痉挛分别为9例、2例,前臂疼痛或不适分别为7例、1例,差异均有统计学意义(P＜0.05).两组导引导管到位、桡动脉创口压迫时间、前臂血肿、止血成功、桡动脉术后直径、桡动脉闭塞及皮肤缺血坏死间差异均无统计学意义(P＞0.05).结论 与常规6F鞘导引导管相比,桡动脉无鞘7F普通导引导管治疗冠状动脉病变安全有效.

Transradial interventional treatment of coronary artery lesions by using sheathless common 7-F guiding catheter: its clinical efficacy

Objective To compare the efficacy and safety of the use of sheathless common 7-F guiding catheter with those of conventional 6-F sheath guiding catheter in performing transradial percutaneous coronary intervention (PCI) for coronary artery lesions.Methods The clinical data of 160 consecutive patients with coronary artery lesions,who were treated with transradial PCI during the period from January 2014 to June 2015,were retrospectively analyzed.The patients were randomly divided into sheathless group (n=80,using sheathless common 7-F guiding catheter) and sheath group (n=80,using conventional 6-F sheath guiding catheter).The accuracy of the guiding catheter placement,the compression time for the punctured radial artery,the success rate of hemostasis,the incidence of radial artery spasm,the postoperative diameter of radial artery,the fading time of swelling at distal arm,the forearm pain or discomfort,the formation of forearm hematoma,the incidence of pseudoaneurysm and radial artery occlusion,the skin ischemia necrosis,etc.were recorded,and the results were compared between the two groups.Results In the sheathless group and the sheath group,the radial artery spasm was observed in 9 patients and 2 patients respectively,the forearm pain or discomfort was seen in 7 patients and one patient respectively,the differences between the two groups were statistically significant (P＜0.05).No statistically significant differences in the accuracy of the guiding catheter placement,the compression time for the punctured radial artery,the formation of forearm hematoma,the success rate of hemostasis,the postoperative diameter of radial artery,the incidence of radial artery occlusion and the skin ischemia necrosis existed between the two groups (P＞0.05).Conclusion Compared to the use of conventional 6-F sheath guiding catheter,the use of sheathless common 7-F guiding catheter is safe and effective in treating coronary artery lesions with transradial PCI.