对比经远端桡动脉与肱动脉入路支架成形术治疗髂动脉慢性闭塞症的有效性及安全性

目的 对比经远端桡动脉入路与肱动脉入路支架成形术治疗髂动脉慢性闭塞症的有效性及安全性。方法 回顾性分析70例接受经左侧桡动脉远端入路（A组）与72例经左侧肱动脉入路（B组）支架成形术治疗髂动脉慢性闭塞症患者，其中B组18例因穿刺左侧桡动脉远端失败而改为穿刺左侧肱动脉；观察2种方法穿刺成功率、2组髂动脉开通成功率和穿刺并发症发生率。结果 穿刺桡动脉远端成功率为79.55%（70/88），穿刺肱动脉成功率为100%（72/72）。髂动脉顺行开通成功率[78.57%（55/70）vs.80.56%（58/72），<χ²=3.67，P=0.09]及总体开通成功率[94.29%（66/70）vs.95.83%（69/72），χ²=2.34，P=0.10]组间差异均无统计学意义。A组穿刺并发症发生率低于B组[5.71%（4/70）vs.13.89%（10/72），<χ²=3.24，P=0.02]。结论 相比经肱动脉入路，经远端桡动脉穿刺入路腔内支架成形术治疗髂动脉慢性闭塞症更为安全，而开通成功率相当。

Comparison on efficacy and safety of distal radial artery and brachial artery approach stent plasty for chronic iliac artery occlusion

Objective To compare the efficacy and safety of distal radial artery and brachial artery approach stent plasty for chronic iliac artery occlusion. Methods Data of 142 patients with chronic iliac artery occlusion who underwent stenting via left distal radial artery approach (group A, n=70) or left brachial artery approach (group B, n=72) were retrospectively analyzed. Puncture of left distal radial artery failed in 18 cases in group B, and the patients then underwent left brachial artery puncture. The successful rate of 2 kinds of puncture, of iliac artery opening, and the incidence of puncture complications were observed and compared between groups. Results The successful rate of distal radial artery puncture was 79.55% (70/88), while of brachial artery puncture was 100% (72/72). The successful rate of anterograde iliac artery opening (78.57%[55/70] vs. 80.56%[58/72], χ²=3.67, P=0.09), the overall successful rate of iliac artery opening (94.29%[66/70] vs. 95.83%[69/72], χ²=2.34, P=0.10) were not significant different between groups. The incidence of puncture complications in group A was lower than that in group B (5.71%[4/70] vs. 13.89%[10/72], χ²=3.24, P=0.02). Conclusion Compared with brachial artery approach, stent plasty via distal radial artery approach for chronic iliac artery occlusion was safe, and the success rate of the two approaches were comparable.