摘要
目的探讨老年患者经右桡动脉途径行经皮冠状动脉介入(percutaneous coronary intervention,PCI)诊疗时,右锁骨下动脉、头臂干迂曲导致导丝、导管不能顺利通过的处理方法。方法自2013年1月至2017年1月,解放军第184医院60岁以上患者行PCI诊疗1 256例次,穿刺成功1 229例次,对于导丝、导管不能一次顺利到达主动脉根部的患者,采取自行摸索的一系列方法进行处理,并归纳出有利于导丝、导管通过的办法。结果通过我们采取的综合处理方法,对于104例次因右锁骨下动脉、头臂干迂曲导致导丝、导管不能一次顺利通过的患者,成功通过98例次,导丝、导管置入成功率提升了7.97%(98/1229),并没有发生相关血管并发症。结论对右锁骨下动脉、头臂干迂曲的老年患者行PCI诊疗,采取我们的一些方法,能够提高导丝、导管通过率,缩短手术时间,提升手术成功率,减少患者痛苦,减少血管并发症,值得推广应用。
Objectives To investigate the processing method for treatment of guiding wire and catheter which could not pass induced by tortuous right subclavian artery and brachiocephalic trunk in elderly patients underwent percutaneous coronary intervention(PCI)through right radial artery approach.Methods During the period from January2013to January2017,a total of1256patients aged more than60years old were treated by PCI.Among them,1229patients were successfully punctured.For the patients whose guiding wire and catheter can not reach the aortic root,we have ad?opted a series of self groping methods to deal with them.We concluded the methods for the guiding wire and catheter to pass through.Results By the means of comprehensive treatment,98of the104patients whose guiding wire and cathe?ter can not pass through finally successfully passed.Successful passing rates of guiding wire and catheter increased7.97%(98/1229),and no vascular complications occured.Conclusions We have got some methods for treatment of guiding wire and catheter which could not pass induced by tortuous right subclavian artery and brachiocephalic trunk in elderly patients underwent PCI through right radial artery approach.By these methods,we can improve passing rates of guiding wire and catheter,shorten operation duration,improve success rate of surgery,reduce the pain of patients and reduce the vascular complications.This technology is worthy of promotion.
作者
王强
祝丽华
WANG Qiang;ZHU Li-hua(Interventional Center,No.184 Hospital of PLA,Yingtan,Jiangxi 335000,China)
出处
《岭南心血管病杂志》
2018年第1期17-21,共5页
South China Journal of Cardiovascular Diseases
关键词
血管成形术
经腔
经皮冠状动脉
桡动脉
锁骨下动脉
头臂干
动脉迂曲
老年
percutaneous coronary intervention
radial artery
subclavian artery
brachiocephalic trunk
artery tortuosity
elderly patients
