|
|
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.
|
Received: 01 March 2023
|
|
|
|
|
[1] |
崔晓明, 杨 炯, 刘志超, 等. 健康体检人群行心电图与冠状动脉CTA筛查冠心病的对比分析[J]. 武警医学,2022,33 (12): 1020-1022.
|
[2] |
马文君,马涵萍,王运红,等. 《2021年中国心血管病医疗质量报告》概要[J]. 中国循环杂志,2021,36(11): 1041-1064.
|
[3] |
谭钧旸,马 芳,胡秋兰,等. 经桡动脉穿刺冠状动脉介入治疗术肢管理的最佳证据总结[J]. 中华护理杂志,2022,57(13): 1572-1579.
|
[4] |
经远端桡动脉行冠状动脉介入诊疗中国专家共识[J]. 中国介入心脏病学杂志,2020,28(12): 667-674.
|
[5] |
陈丽斐,张艳红,朱 娟,等. 鼻烟窝桡动脉远端穿刺在经皮冠状动脉介入治疗患者中的应用[J]. 护理实践与研究,2020,17(15): 46-47.
|
[6] |
Lu Y, Zhang H, Wang Y, et al. Percutaneous coronary intervention in patients without acute myocardial infarction in China: results from the China PEACE prospective study of percutaneous coronary intervention[J]. JAMA Netw Open, 2018, 1(8):e185446.
|
[7] |
Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI)[J]. Euro Intervention, 2017, 13(7): 851-857.
|
[8] |
Nikolakopoulos I, Vemmou E, Brilakis E S. Distal radial access for cardiac catheterization: when and how[J]. Hellenic J Cardiol, 2020, 61(2): 110-111.
|
[9] |
Ruzsa Z, Achim A. Distal radial access: no pain, no gain[J]. Kardiol Pol, 2022, 80(6):633-634.
|
[10] |
Cao J, Cai H, Liu W, et al. Safety and effectiveness of coronary angiography or intervention through the distal radial access: a meta-analysis[J]. J Interv Cardiol, 2021, 2021: 4371744.
|
[11] |
Sgueglia G A, Santoliquido A, Gaspardone A, et al. First results of the distal radial access doppler study[J]. JACC Cardiovasc Imaging, 2021, 14(6): 1281-1283.
|
[12] |
梁宇鹏,刘培中,张和针, 等. 经鼻烟壶区桡动脉穿刺置管术用于冠状动脉介入术的安全性观察及体会[J]. 广东医学,2022,43(6): 777-780.
|
|
|
|