摘要
目的对桡动脉痉挛情况下经6FJudkin造影导管急诊直接行经皮冠状动脉介入治疗(PCI)的可行性进行探讨。方法选取桡动脉痉挛情况下经6F造影导管直接行PCI的急性心肌梗死(AMI)患者18例(病例组)以及改行股动脉径路PCI的AMI患者20例(对照组),观察临床基本情况、术中病变类型、手术成功率、植入支架时间(开始送导丝至支架植入完成)、手术时间、急诊室至球囊扩张(DTB)时间、术中曝光时间、对比剂用量以及术后并发症。结果两组间基线资料的差异均无统计学意义(P值均>0.05)。病例组和对照组的手术成功率分别为17/18和20/20,对比剂用量分别为(155±42)、(163±56)mL,曝光时间分别为(17±3)、(15±6)min,植入支架时间分别为12(7,22)min和14(9,20)min,两组间的差异均无统计学意义(P值均>0.05)。而病例组和对照组的手术时间分别为(40±8)、(58±7)min,DTB时间分别为(114±28)、(148±32)min,两组间的差异均有统计学意义(P值分别<0.01、0.05)。结论行桡动脉径路急诊PCI时,若在造影时出现桡动脉痉挛,直接经造影管行PCI是可行的。
Objective To discuss the feasibility of percutaneous coronary intervention（PCI）in patients with acute myocardial infarction（AMI）by radial artery approach using 6F Judkin angiographic catheter during radial artery spasm.（Shanghai Med J,2010,333：744-746）Methods Eighteen AMI patients who received PCI by radial artery approach with 6F Judkins angiographic catheter due to tortuous radial artery and/or radial artery spasm and another 20 AMI patients who received PCI by transfemoral approach due to radial problems were enrolled in this study.The clinical data,the characteristics of target lesion,the status of PCI,the successful rate of operation,the operation time of implanting stent（from 0.014″ wire entering the catheter to implanting stent）,the door-to-balloon（DTB）time,the operation time,the amount of contrast media,and the complications after operation were all observed.Results The clinical baseline data were similar in the two groups.The successful rate of operation was 17/18 in group A and 20/20 in group B（P〈0.05）.The amount of contrast media was（155±42）mL in group A and（163±56）mL in group B（P〈0.05）.The fluoroscopy time during catheterization was（17±3）min in Group A and（15±6）min in Group B（P〈0.05）.The operation time of implanting stent was 12（7,22）min in group A and 14（9,20）min in group B（P〈0.05）.The operation time and the DTB were significantly shorter in the group A than in group B（[40±8] vs.[58±7],P〈0.01;[114±28] min vs.[148±32] min,P〈0.05）.Conclusion It is feasible to perform PCI in AMI patients by radial artery approach using 6F Judkin angiographic catheter when there are tortuous radial pathways and/or the radial artery spasm.（Shanghai Med J,2010,33：744-746）
出处
《上海医学》
CAS
CSCD
北大核心
2010年第8期744-746,共3页
Shanghai Medical Journal
关键词
桡动脉痉挛
造影导管
急性心肌梗死
经皮冠状动脉介入治疗
Radial artery spasm
Angiographic catheter
Acute myocardial infarction
Percutaneous coronary intervention
