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目的:探讨经皮冠状动脉介入治疗时球囊辅助通过(balloon-assisted tracking,BAT)技术辅助指引导管通过桡动脉径路痉挛血管的安全性和有效性。方法:回顾性分析2014年6月至2016年9月复旦大学附属中山医院心内科经桡动脉径路行冠状动脉介入治疗患者资料,筛选出桡动脉和(或)肱动脉痉挛患者69例。其中,应用BAT技术处理痉挛24例(BAT组),常规方法处理痉挛45例(常规组)。比较两种方法指引导管通过痉挛段血管的成功率及相关并发症的发生率。结果:BAT组24例指引导管均顺利通过痉挛或夹层段血管,成功率达100%;而常规组仅14例(31.1%)顺利通过(P=0.000)。BAT组指引导管在<5min、5~15min、>15min通过者分别为20例(83.3%)、3例(12.5%)、1例(4.2%);常规组指引导管在<5min、5~15min、>15min通过者分别为2例(14.3%)、6例(42.9%)、6例(42.9%)。BAT组和常规组患者前臂血肿发生率分别为8.3%、20%,但差异无统计学意义。结论:经桡动脉径路进行经皮冠状动脉介入术遇到血管痉挛时,采用BAT技术可高效、安全地引导指引导管通过痉挛或夹层段血管,优于常规处理技术。
OBJECTIVE: To investigate the safety and efficacy of balloon-assisted tracking (BAT) technique in guiding percutaneous coronary intervention in the vasospasm of radial artery. Methods: Sixty-nine patients with radial artery and / or brachial artery spasm were selected from the Department of Cardiology of Zhongshan Hospital of Fudan University from June 2014 to September 2016 through the radial artery approach. Among them, 24 cases of spasticity (BAT group) were treated with BAT technique and 45 cases of conventional treatment of spasticity (conventional group). Two methods were compared to guide the success rate of the vessel through the spasm segment and the incidence of related complications. RESULTS: Twenty-four cases of guiding catheters in BAT group successfully passed the spasm or dissection vessel, with a success rate of 100%. Only 14 patients (31.1%) in the conventional group passed the test successfully (P = 0.000). In the BAT group, 20 (83.3%), 3 (12.5%) and 1 (4.2%) patients underwent catheterization within 5 minutes, 5 minutes to 15 minutes, and 15 minutes respectively. (14.3%), 6 cases (42.9%) and 6 cases (42.9%), respectively. The incidence of forearm hematoma in patients in BAT group and routine group were 8.3% and 20%, respectively, but the difference was not statistically significant. Conclusion: When transradial approach to vasospasm is involved in percutaneous coronary intervention, the BAT technique can be used to guide the guide catheter through the spasm or dissection vessel efficiently and safely, which is superior to conventional treatment.