中华医学杂志（英文版）2008，Vol.121Issue(9)：782-786,5.
Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction
Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction
YAN Zhen-xian 1ZHOU Yu-jie 1ZHAO Ying-xin 1LIU Yu-yang 1SHI Dong-mei 1GUO Yong-he 1CHENG Wan-jun1
作者信息
- 1. Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China
- 折叠
摘要
Abstract
Background Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI).Methods A total of 103 consecutive elderly patients (age≥65 years) who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach (transradial intervention, TRI group),and 46 underwent primary PCI via the transfemoral approach (transfemoral intervention, TFI group). The success rate of puncture, puncture time, cannulation time, reperfusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump (IABP), and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events (MACE) in the two groups in one month were observed.Results The success rates of puncture (98.2% vs 100.0%) and PCI (96.5% vs 95.7%) for the patients in the TRI and TFI groups were not statistically significant (P>0.05). The puncture time ((2.4±1.1) vs (2.0±0.9) minutes), cannulation time ((2.7±0.5) vs (2.6±0.5) minutes), reperfusion time ((16.2±4.5) vs (15.4±3.6) minutes), total time of the procedure ((44.1±6.8) vs (41.2±5.7) minutes), use rates of temporary pacemaker (1.8% vs 2.2%) and IABP (0 vs 2.2%) in the two groups were not statistically significant (P>0.05), but the hospital stay of the TFI group was longer than that of the TRI group ((10.1±4.6) VS (7.2±2.6) days, P<0.01). A radial occlusion was observed in the TRI group, but no ischemic syndrome in hand. In the TFI group, 4 patients had hematosis, 1 had pseudoaneurysm, and 1 had major bleeding.Statistical significance in vascular access site complications was seen in the two groups (1.8 % vs 13.1%, P<0.05). Three patients died in the two groups respectively in one month, and there was no statistical significance in MACE in the two groups (5.3% vs 6.5%, P>0.05).Conclusion The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.关键词
transradial/ transfemoral/ percutaneous coronary intervention/ acute myocardial infarction/ elderlyKey words
transradial/ transfemoral/ percutaneous coronary intervention/ acute myocardial infarction/ elderly分类
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YAN Zhen-xian,ZHOU Yu-jie,ZHAO Ying-xin,LIU Yu-yang,SHI Dong-mei,GUO Yong-he,CHENG Wan-jun..Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction[J].中华医学杂志（英文版）,2008,121(9):782-786,5.
