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经桡动脉行PCI桡动脉痉挛时指引导管通过的不同方法的对比研究

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摘要:

目的 探讨经桡动脉途径行经皮冠状动脉介入治疗(PCI)桡动脉痉挛时MPA1导管辅助跟
踪指引导管通过方法的有效性及安全性。方法 选择2021年2月至2021年12月于解放军总医院第七医学中
心心内科导管室经桡动脉造影确诊为冠状动脉粥样硬化性心脏病(冠心病),后续行PCI时发生桡动脉
痉挛的患者44例,随机分为药物治疗组和导管辅助组,每组各22例。药物治疗组给予常规的解痉药物,
导管辅助组应用MPA1导管辅助跟踪指引导管以通过痉挛的桡动脉,比较两组指引导管通过痉挛桡动脉
的成功率、指引导管通过痉挛桡动脉时的通过时间和术后及随访时桡动脉损伤相关并发症。结果 导管
辅助组指引导管均能顺利通过桡动脉痉挛部位(22例),成功率为100%,药物治疗组顺利通过桡动脉痉
挛部位仅15例,成功率为68.18%,导管辅助组指引导管通过时间较药物治疗组明显缩短,且术后及随访
时动脉损伤相关并发症低于药物治疗组,差异具有统计学意义(P<0.05)。结论 MPA1导管辅助跟踪指
引导管通过痉挛的桡动脉安全有效、成功率高,且明显缩短操作时间。

Abstract:

Objective To discuss the effective and safety of MPA1 catheter in aiding and tracing the guiding catheter passage during radial artery spasm induced by transradial coronary intervention (TRI). Methods The patients (n=44) with coronary heart disease (CHD) diagnosed by transradial echocardiography and suffered from radial artery spasm during TRI were chosen from Department of Cardiology in the Seventh Medical Center of PLA General Hospital from Feb. 2021 to Dec. 2021, and divided randomly into medication group and catheter-assisted group (each n=22). The routine antispasmodic drugs was used in medication group, and MPA1 catheter was used in catheter-assisted group for aiding and tracing the guiding catheter to pass through spasmodic radial artery. The success rate and time of guiding catheter passing through spasmodic radial artery, and complications related to radial artery damage were compared between 2 groups after the operation and in follow-up period. Results The guiding catheter all passed through smoothly the spasmodic radial artery in 22 cases and success rate was 100% in catheter-assisted group, and guiding catheter passed smoothly through the spasmodic radial artery only in 15 cases and success rate was 68.18% in medication group. The comparison between 2 groups showed that the time of guiding catheter passage was significantly shorter, and complications related to radial artery damage after the operation and in follow-up period were less in catheter-assisted than those in medication group (P<0.05). Conclusion MPA1 catheter is safe and effective with higher success rate and short operative time in aiding and tracing the guiding catheter passing through spasmodic radial artery.

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