成万钧,周玉杰,赵迎新,郭永和,曹政,王建龙

• 1:首都医科大学附属北京安贞医院心内科12病房

摘要(Abstract)：

目的评价经桡动脉途径冠状动脉介入治疗无保护左主干病变的可行性和安全性。方法2004年3月至2006年9月,分别经桡动脉(36例)或股动脉(51例)途径完成87例无保护左主干病变患者的冠状动脉介入治疗,并观察不同入路介入治疗左主干病变的成功率、手术操作时间、造影剂用量、术后并发症以及临床随访期间发生严重心脏不良事件(MACE)的情况。结果在37例选择经桡动脉介入治疗的患者中仅1例患者因术中出现桡动脉痉挛而改为股动脉途径,桡动脉介入治疗的手术成功率为97.3%,两组患者完成手术的操作时间(59.2±15.0 mm比56.9±22.3 m in)和造影剂用量(216±33 mL比205±41 mL)无明显差异,但经桡动脉途径介入治疗患者血管并发症的发生率(0)明显低于股动脉介入治疗患者(3.9%);临床随访6个月,仅1例股动脉介入治疗组患者死亡,分别有1例经桡动脉介入患者和2例经股动脉介入治疗患者随访期间接受了靶病变血运重建(TLR)治疗,随访期间总MACE的发生率桡动脉组为3.1%,股动脉组患者为5.7%,两组患者间差异无统计学意义。结论相比于股动脉途径,经桡动脉途径冠状动脉介入治疗无保护左主干病变具有同样的临床效果,而且血管并发症的发生率要明显低于股动脉途径的介入治疗。

关键词(KeyWords)： 冠状动脉疾病;血管成形术,经腔,经皮冠状动脉;桡动脉;股动脉

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 成万钧,周玉杰,赵迎新,郭永和,曹政,王建龙

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