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|本期目录/Table of Contents|

经桡动脉行无保护左主干病变介入治疗

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第1期
页码:
105-106,110
栏目:
临床研究
出版日期:
2010-01-04

文章信息/Info

Title:
Percutaneous coronary intervention via radial artery for unprotected left main coronary artery diseases
作者:
汝磊生; 齐书英; 孙家安; 杨丽; 彭育红; 梅静; 杨莉
解放军白求恩国际和平医院心内科,河北 石家庄 050082
Author(s):
RU Lei-sheng;  QI Shu-ying;  SUN Jia-an;  YANG Li;  PENG Yu-hong;  MEI Jing;  YANG Li
Department of Cardiology, Bethune International Peace Hospital, Shijiazhuang 050082, Hebei, China
关键词:
左主干病变; 冠状动脉介入治疗; 经皮; 桡动脉; 并发症
Keywords:
left main coronary artery;  percutaneous coronary intervention;  radial artery;  complications
分类号:
-
DOI:
-
文献标识码:
A
摘要:
目的: 回顾性总结29例冠状动脉造影发现为无保护左主干开口及体部狭窄病例的冠脉介入治疗(PCI)资料，以探讨手术的安全性和可行性。方法: 术前给予常规药物治疗，经桡动脉途径行PCI，观察桡动脉穿刺成功率、PCI即刻成功率、手术时间、支架扩张时间和扩张压力、住院期间严重并发症发生率、出院前心绞痛发作情况评估及术前心电图（ECG）特点分析。结果: 29例患者桡动脉穿刺成功率和PCI即刻成功率均为100％，手术时间25～50（38±8）min，支架扩张时间3～7（5±1.3）s，支架扩张压力14～20（16.0±1.9）atm (1 atm=101.325 kPa)，住院期间无严重并发症发生，前臂肿胀3例，术后心绞痛显著缓解。术前胸痛发作时ECG特点：典型“左主干”心电图17例，胸前导联ST-T改变者10例，间歇性左束支阻滞2例。结论: 经桡动脉途径对无保护左主干开口和体部病变行PCI治疗，成功率高，安全有效。
Abstract:
AIM: To assess the safety and feasibility of percutaneous coronary intervention (PCI) via radial approach for unprotected left main coronary artery stenosis. METHODS: Twenty nine patients with unprotected left main coronary artery stenosis were treated with PCI via radial approach and the parameters examined were successful recanalization of PCI, surgical time, dilating time and pressure of stent, along with in-hospital complications. RESULTS: The success rate of radial artery puncture and PCI was 100%. Surgical time was 25-50 min (average 30 min). Dilating time was 3-7 sec (average 5 sec) and dilating pressure was 14-20 atmospheres (average 16). There were no severe in-hospital complications. CONCLUSION: PCI via radial artery is safe and effective for patients with left main lesions. There is a high success rate.

参考文献/References

［1］ Silber S, Albertsson P, Aviles FF, et al. Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology［J］. Eur Heart J, 2005, 26(8):804-847.

［2］ Valgimigli M, van Mieghem CA, Ong AT, et al. Short- and long- term clinical cutcome after drug-eluting stent implitation for the percutaneous treatment of left main coronary artery disease:insights from the Rapamycin-Eluting and Taxus Stent Evaluated At Rotterdam Cardiology Hospital registries(RESEACH and T-SEACH)［J］. Circulation, 2005, 111(11):1383-1389.

［3］ Park SJ, Park SW, Hong MK, et al. Long term(three years) outcomes after stenting of unprotected left main coronary artery stenosis in patients with normal left ventricular function［J］. Am J Cardiol, 2003, 91(1):12-16.

［4］ 无保护左主干病变的选择性支架术协作组. 无保护左主干病变的选择性支架术［J］. 中华心血管病杂志， 2000， 28（5）：346-348.

［5］ Chieffo A, Morici N, Maisano F, et al. Percutaneous treatment wth drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis: a single-center experience［J］. Circulation, 2006, 113(21):2542-2547.

［6］ 陈万强,薛成相,张红宾,等.经桡动脉和股动脉途径行冠状动脉造影的对比研究［J］. 医师进修杂志, 2004, 27(4):26-27.

［7］ Kiemeneij F, Laarman GJ, Odekerken D, et al. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study［J］. J Am Coll Cardiol, 1997, 29(6):1269-1275.

备注/Memo

备注/Memo:
收稿日期：2008-12-23.作者简介：汝磊生，副主任医师，博士Email:rls9377@hotmail.com
更新日期/Last Update: 2010-01-05