Comparative analysis on effects of two radial artery accesses for patients undergoing coronary intervention
ZHUANG Jian, LIU Changxing, SHI Rui, GUO Qing, CAI Wei, ZHANG Xin, NI Jianmei, LIANG Guoqing
Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristics Medical Center of Chinese People's Armed Police Force/Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Tianjin 300162, China
Abstract：Objective To compare and analyze the effects of distal transradial artery access (dTRA) in the anatomical snuffbox and transradial artery access (TRA) for patients undergoing coronary intervention. Methods The clinical data of 182 patients with coronary heart disease who underwent CAG or PCI at Characteristics Medical Center of CPAPF from January 2017 to December 2018 were retrospectively analyzed, and then 145 cases were screened in the study, of which 68 cases underwent dTRA approach and 77 cases underwent TRA approach. We collected preoperative baseline characteristics of all patients, and compared the indicators of intraoperative one-time puncture success rate, duration of arterial punctures, postoperative compression time, pain in operative area, limb comfort, postoperative complications and patient satisfaction. Results There was no significant differences in preoperative baseline data between the two groups. Cases of one-time puncture success in dTRA group and TRA group were 56(82.35%) and 71(92.21%) respectively, and no significant difference was found (χ2=3.225, P=0.083). Compared with TRA group, , The duration of arterial punctures in dTRA group was prolonged [(18.72±3.29) min vs. (8.87±2.72) min, t=-19.705, P<0.001], but postoperative compression hemostasis time was significantly reduced [(2.40±0.49) h vs. (5.72±0.61) h, t=35. 853, P<0.001],. Comparative analysis of postoperative observation indicators showed that operative limb pain was alleviated (P<0.001) and postoperative complications was reduced (P<0.05) in dTRA group, mainly manifested as postoperative hematoma, occasional pseudoaneurysm, and no radial artery occlusion. The satisfaction of patients with surgery in dTRA group was higher than that in TRA group (Very satisfied, 22.06% vs. 1.30%; Satisfied, 75.00% vs. 86.61%; Not satisfied, 2.94% vs. 9.09%) (P<0.05). Conclusions The application of dTRA access is beneficial to postoperative recovery of patients, and reduces postoperative complications. However, because of high technical difficulty, skill training should be paid mor attention in its clinical promotion.
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2023, Vol. 34 
