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目的探讨经桡动脉冠状动脉介入诊疗的可行性及安全性。方法选择符合冠状动脉造影指征并A llen’s试验阳性患者255例,以右桡动脉途径行冠状动脉造影,对符合介入治疗指征者行介入治疗。结果造影成功243例,成功率95.3%;失败12例,其中5例为穿刺不成功(桡动脉痉挛5例,桡动脉斑块狭窄2例)。造影成功者中对144例患者行介入治疗,142例成功置入支架278枚,成功率98.6%,失败2例均因痉挛指引导管无法到位。造影及介入治疗不成功者改股动脉途径均获成功。术后9例血管神经性水肿,7例出现术侧桡动脉波动减弱(无桡动脉闭塞夹层等)。皮下瘀斑2例,小血肿5例,迷走反射发生4例。结论经桡动脉行冠状动脉介入诊疗安全可行,创伤小,并发症少,患者易于接受,值得推广。
Objective To investigate the feasibility and safety of transradial coronary intervention. Methods A total of 255 patients were selected according to the indications of coronary angiography and Alen’s test. Coronary angiography was performed with the right radial artery and interventional treatment was performed in accordance with the indications of interventional therapy. Results 243 cases of successful angiography, the success rate of 95.3%; failed in 12 cases, of which 5 cases failed puncture (radial artery spasm in 5 cases, radial artery plaque in 2 cases). Of the 144 patients who underwent angiography, there were 144 patients who underwent interventional therapy, 142 of them successfully placed 278 stents with a success rate of 98.6%. Both failed to guide the catheter due to spasticity. Angiography and interventional therapy unsuccessful to the femoral artery approach have been successful. After operation, 9 cases had angioedema, and 7 cases showed weakened radial artery (no radial artery occlusion, etc.). Subcutaneous ecchymosis in 2 cases, 5 cases of small hematoma, vagal reflex occurred in 4 cases. Conclusions Transradial coronary intervention is safe and feasible, with less trauma and fewer complications. Patients are easily accepted and worthy of promotion.