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目的:比较经右桡动脉应用Tiger I导管和左、右Judkins导管行冠状动脉造影的安全性、可行性。方法:①对象:选择2007-04/10南京医科大学附属南京第一医院心内科欲行冠状动脉造影患者200例,男123例,女77例,平均年龄(58±8)岁,随机分为2组,每组100例。患者对治疗知情同意。②方法:两组均采用经右桡动脉径路,一组用6F Judkins L(JL)3.5、Judkins R(JR)3.5造影导管(美国Cordis公司生产)作为首选导管,如大小不适合可换用6FJL4.0、JR4.0或别的造影导管;另一组用TigerI导管(日本Terumo公司生产),如左冠状动脉或右冠状动脉插管不能成功或不能满意到位均视为Tiger I导管插管失败,需换用左或右Judkins导管或别的造影导管。每例患者导管均必须满意到达左、右冠状动脉开口并能获得清晰的影像,否则计为插管失败。③评估:观察各组中左右冠状动脉造影的成功率、造影时间、曝光时间、造影剂的用量、造影术中和导管有关的并发症的发生率、导管费用。结果:①经右桡动脉用Tiger I导管行左右冠状动脉造影成功率是94%,Judkins导管成功率100%(P<0.05)。②造影时间:Judkins导管(318.3±47.9)s、Tiger I导管(318.5±49.0)s(P>0.05)。③曝光时间:Judkins导管(1.8±0.9)min、Tiger I导管(1.9±0.6)min(P>0.05)。④造影剂的用量:Judkins导管(42.6±6.4)mL、TigerI导管(34.2±5.0)mL(P<0.05)。⑤造影术中和导管有关的并发症的发生率均为0。⑥Judkins导管费用(530.4±51.2)元、Tiger I导管费用(260±0)元。⑦材料与宿主的生物相容性:采用TigerI导管与Judkins导管行冠状动脉造影的患者均未出现血小板异常、局部炎症、全身不适等反应。结论:Tiger I导管在经右桡动脉径路的冠状动脉造影中的应用是安全、可行的,未发现特殊生物相容性问题;在造影成功率方面Judkins导管优于Tiger I导管;在减少造影剂用量、降低导管费用方面Tiger I导管优于Judkins导管。
Objective: To compare the safety and feasibility of coronary artery angiography with Tiger I catheter and left and right Judkins catheters through the right radial artery. Methods: ① Subjects: Selected 2007-04 / 10 Nanjing Medical University Affiliated Nanjing First Hospital Department of Cardiology 200 patients with coronary artery angiography, 123 males and 77 females, mean age (58 ± 8) years of age, were randomly divided into 2 groups, 100 cases in each group. Patient informed consent for treatment. Methods: The right radial artery path was used in both groups. A group of 6F Judkins L (JL) 3.5 and Judkins R (JR) 3.5 angiography catheters (Cordis, USA) was selected as the catheter of choice. 6FJL4 .0, JR4.0 or other contrast catheter; the other group with TigerI catheter (Japan Terumo company), such as the left coronary artery or right coronary artery cannulation can not be successful or not satisfied with the place are considered Tiger I catheter failed , Need to change left or right Judkins catheter or other contrast catheter. Each patient’s catheter must be satisfactorily reached the left and right coronary arteries and have a clear view of the catheter, or failure of intubation. ③ Evaluation: To observe the success rate of coronary angiography in each group, contrast time, exposure time, the amount of contrast medium, angiography and catheter-related complications, catheter costs. Results: ① The success rate of right and left coronary angiography through the right radial artery with Tiger I catheter was 94% and the success rate of Judkins catheter was 100% (P <0.05). The imaging time was: Judkins catheter (318.3 ± 47.9) s, Tiger I catheter (318.5 ± 49.0) s (P> 0.05). ③ The exposure time: Judkins catheter (1.8 ± 0.9) min, Tiger I catheter (1.9 ± 0.6) min (P> 0.05). ④ The amount of contrast agent: Judkins catheter (42.6 ± 6.4) mL, TigerI catheter (34.2 ± 5.0) mL (P <0.05). ⑤ imaging and catheter-related complications were all 0. ⑥Judkins catheter costs (530.4 ± 51.2) yuan, TigerI catheter costs (260 ± 0) yuan. ⑦ Biocompatibility of Materials and Hosts: No abnormal platelet abnormalities, local inflammation, general malaise, etc. were observed in patients undergoing coronary angiography with the TigerI catheter and the Judkins catheter. Conclusions: The use of the Tiger I catheter in coronary angiography via the right radial artery is safe and feasible with no specific biocompatibility problems; the Judkins catheter is superior to the Tiger I catheter in terms of imaging success; Tiger I catheter is superior to Judkins catheter in terms of volume and catheter cost.