摘要: |
目的 比较经双侧桡动脉入路与经桡股复合入路行冠状动脉慢性完全闭塞(chronic total occlusion, CTO)介入治疗的有效性和安全性。方法 纳入经双侧桡动脉入路或经桡股动脉复合入路实施冠状动脉 CTO 介入治疗的患者。对比2 组患者基线数据,手术策略,术中参数(手术时间、曝光时间、射线量、造影剂用量和肝素用量等),手术成功率和术后并发症情况。结果 本研究共纳入 336 例患者,其中 76.8% 的患者经双侧桡动脉入路完成介入治疗。与经桡股动脉复合入路组相比,经双侧桡动脉入路组手术时间短,造影和肝素用量少(P<0.05)。经双侧桡动脉入路组手术成功率不劣于经桡股动脉复合入路组(P>0.05)。经双侧桡动脉入路行冠状动脉 CTO 介入治疗,出现冠状动脉穿孔、血管入路并发症及急性肾损伤的比例显著降低(P<0.05)。结论 经双侧桡动脉入路已成为冠状动脉 CTO 介入治疗的重要入路,其有较高的手术成功率和安全性,值得临床进一步推广应用。 |
关键词: 冠状动脉慢性完全闭塞 经皮冠状动脉介入治疗 双侧桡动脉入路 桡股复合入路 |
DOI:10.12025/j.issn.1008-6358.2024.20240095 |
分类号:R 541.4 |
基金项目:国家重点研发计划(2021YFC2500500),上海市优秀学术带头人计划(22XD1423300),上海市临床重点专科项目(shslczdzk01701). |
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Efficacy and safety analysis of bilateral radial access versus combined radial and femoral access in the interventional treatment of coronary chronic total occlusion |
LAN Jinling1, CHEN Kun2, HUANG Jia3, DAI Yuxiang3, GE Junbo3
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1.Huaping County Traditional Chinese Medicine Hospital, Lijiang 674800, Yunnan, China;2.Changde Hospital, Xiangya School of Medicine, Central South University, The First People's Hospital of Changde, Changde 415003, Hunan, China;3.Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Abstract: |
Objective To compare the efficacy and safety of biradial access with combined radial and femoral access for interventional treatment of coronary chronic total occlusion (CTO). Methods Patients who underwent coronary artery CTO intervention via bilateral radial access or combined radial and femoral access were included. Baseline data, surgical strategy, intraoperative parameters (surgical time, exposure time, radiation dose, contrast agent dosage, and heparin dosage), surgical success rate, and postoperative complications between two groups of patients were compared. Results A total of 336 patients were included in this study, of which 76.8% completed interventional treatment via biradial access. Compared with combined radial and femoral access group, procedural duration, contrast volume and heparin consumption were reduced in biradial access group (P<0.05). The success rate of surgery in the bilateral radial access group was not inferior to that in the combined radial and femoral access group (P> 0.05). In addition, biradial access compared with combined radial and femoral access was associated with a significant reduction in incidence of coronary perforation, access vascular complications and acute kidney injury (P<0.05). Conclusions Due to its efficacy and safety in CTO-PCI, biradial access is widely applied in current CTO-PCI and deserved broader application in the future. |
Key words: coronary chronic total occlusion percutaneous coronary intervention biradial access combined radial and femoral access |