球囊辅助通过技术处理桡动脉痉挛的有效性和安全性

发布时间：2025-09-24 02:22

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球囊辅助通过技术处理桡动脉痉挛的有效性和安全性

复旦大学附属中山医院心内科，上海200032

计量文章访问数: 02531 HTML全文浏览量: 0 PDF下载量: 01420 出版历程刊出日期: 2017-06-24

摘要

摘要: 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＜5 min、5~15 min、＞15 min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＜5 min、5～15 min、＞15 min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。

Abstract: Objective：To evaluate the safety and efficacy of balloonassisted tracking (BAT) technique in guiding the catheter through the spastic radial artery via percutaneous coronary intervention. Methods：The data of patients who received coronary intervention through the transradial approach in Department of Cardiology of Zhongshan Hospital Affiliated to Fudan University from June 2014 to September 2016 were retrospectively analyzed. 69 cases of radial artery and / or brachial artery spasm were selected, of which 24 cases were treated with BAT technique (group BAT), and 45 cases were treated by the conventional method (conventional group). The success rate of the catheter through the spastic segment and the incidence of related complications were compared between the two methods. Results：In the BAT group, the guide catheter was successfully negotiated across the spastic segment or dissecting vessels in all 24 cases (100%), while in only 14 cases (31.1%) in the conventional group (P=0.000). Guide catheter traversing the spastic segment within 5min, between 5min and 15min, and more than 15min was seen in 20 (83.3%), 3 (12.5%) and 1 (4.2%) patients in the BAT group, while in 2 (14.3%), 6(42.9%) and 6 (42.9%) patients in the conventional group, respectively (P=0.000). Incidence of forearm hematoma was 8.3% and 20% in the BAT group and the conventional group, and the difference was not statistically significant. Conclusions：The BAT technique is a safe and effective way to guide the catheter through the spasm of radial and/or brachial artery via percutaneous coronary intervention. BAT is superior to the conventional technique.

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