冠心病患者经桡动脉介入治疗后桡动脉闭塞的相关因素分析

详细信息    查看全文 | 推荐本文 |

英文篇名：Occurrence of radial artery occlusion after transradial interventional therapy in patients with coronary artery disease 作者：刘学庆 ; 朱红涛 ; 芮立美 ; 李斌义 ; 邱林林 ; 丁晓军 ; 赵剑峰 ; 郑亚国 ; 林松 英文作者：LIU Xueqing;ZHU Hongtao;RUI Limei;Department of Cardiology,People's Hospital of Danyang; 关键词：桡动脉闭塞 ; 冠心病 ; 介入治疗 英文关键词：Radial artery occlusion;;Coronary artery disease;;Interventional therapy 中文刊名：YIYA 英文刊名：Jiangsu Medical Journal 机构：丹阳市人民医院心内科;丹阳市人民医院超声科;南京市第一医院心内科; 出版日期：2019-07-30 出版单位：江苏医药 年：2019 期：v.45 基金：南京市卫健委重点卫生项目(ZKX16049) 语种：中文; 页：YIYA201907008 页数：3 CN：07 ISSN：32-1221/R 分类号：32-34

摘要

目的分析冠心病患者经桡动脉介入治疗后桡动脉闭塞(RAO)发生的相关因素。方法选取96例接受经桡动脉介入治疗的冠心病患者,于术后1周、1个月及3个月采用多普勒超声检测穿刺侧桡动脉是否闭塞,根据1周时超声结果将患者分为RAO组(14例)及无RAO组(82例),比较两组患者的基本资料,分析RAO发生的相关因素。结果术后1周,女性患者RAO发生率为25.0%(9/36),高于男性患者的8.3%(5/60)(P<0.05);低体重患者RAO发生率为30.8%(4/13),高于正常体重患者的12.0%(10/83)(P<0.01)。RAO组术后随访1个月和3个月时分别有2例和8例桡动脉再通。结论经桡动脉介入治疗的冠心病患者中,女性及低体重患者较为容易发生RAO。术后3个月后超过半数的闭塞桡动脉可再通。
        Objective To analyze the factors related to the occurrence of radial artery occlusion(RAO) after transradial interventional therapy in the patients with coronary artery disease.MethodsNinety-six patients with coronary artery disease underwent transradial intervention therapy.The patency of the radial artery was examined with Doppler ultrasound at one week,one month and 3 months after surgery.According to the results of ultrasound at one week,the patients were divided into group RAO(14 cases) and group NO-RAO(82 cases).The factors relevant to the RAO occurrence were analyzed.Results The incidence of RAO was higher in female patients than that in male one week after surgery [25.0%(9/36) vs.8.3%(5/60)](P<0.05).The incidence of RAO was higher in the patients with low body weight than that in those with nomal weight one week after surgery [30.8%(4/13) vs.12.0%(10/83)](P<0.01).During the follow-up of 1 month and 3 months,the recanalization of the occluded radial artery was seen in 2 patients and 8 patients,respectively.Conclusion RAO occurres more commonly in females and the patients with low body weight in the patients with coronary artery disease undergoing transradial intervention.More than half of the occluded radial arteries becomes repatent 3 months after surgery.

引文

[1] 中华医学会心血管病学分会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):380-393.
    [2] Ibanez B,James S,Agewall S,et al.2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)[J].Eur Heart J,2018,39(2):119-177.
    [3] Jolly SS,Yusuf S,Cairns J,et al.Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL):a randomised,parallel group,multicentre trial[J].Lancet,2011,377(9775):1409-1420.
    [4] Bernat I,Horak D,Stasek J,et al.ST-segment elevation myocardial infarction treated by radial or femoral approach in a multicenter randomized clinical trial:the STEMI-RADIAL trial[J].J Am Coll Cardiol,2014,63(10):964-972.
    [5] Dehghani P,Mohammad A,Bajaj R,et al.Mechanism and predictors of failed transradial approach for percutaneous coronary interventions[J].JACC Cardiovasc Interv,2009,2(11):1057-1064.
    [6] Vefali V,Arslan U.Our experience with transradial approach for coronary angiography[J].Turk Kardiyol Dern Ars,2008,36(3):163-167.
    [7] Coppola J,Patel T,Kwan T,et al.Nitroglycerin,nitroprusside,or both,in preventing radial artery spasm during transradial artery catheterization[J].J Invasive Cardiol,2006,18(4):155-158.
    [8] Dharma S,Shah S,Radadiya R,et al.Nitroglycerin plus diltiazem versus nitroglycerin alone for spasm prophylaxis with transradial approach[J].J Invasive Cardiol,2012,24(3):122-125.
    [9] Garg N,Madan BK,Khanna R,et al.Incidence and predictors of radial artery occlusion after transradial coronary angioplasty:Doppler-guided follow-up study[J].J Invasive Cardiol,2015,27(2):106-112.
    [10] Sinha SK,Jha MJ,Mishra V,et al.Radial artery occlusion- incidence,predictors and long-term outcome after TRAnsradial catheterization:clinico-Doppler ultrasound-based study (RAIL-TRAC study)[J].Acta Cardiol,2017,72(3):318-327.
    [11] Stella PR,Kiemeneij F,Laarman GJ,et al.Incidence and outcome of radial artery occlusion following transradial artery coronary angioplasty[J].Cathet Cardiovasc Diagn,1997,40(2):156-158.
    [12] Rashid M,Kwok CS,Pancholy S,et al.Radial artery occlusion after transradial interventions:a systematic review and meta-analysis[J].J Am Heart Assoc,2016,5(1):e002686.