荆全民 1黄贵奇 2韩雅玲 1王守力 1马颖艳 1王效增 1王耿 1王斌 1徐凯1
作者信息
- 1. 110016 沈阳 沈阳军区总医院心内科
- 2. 343000 江西井冈山 井冈山大学附属医院心内科
- 折叠
摘要
Abstract
Objective To compare the safety, feasibility, and clinical efficacy of transradial approach (TRA) percutaneous coronary intervention (PCI) with transfemoral approach (TFA) PCI for unprotected left main coronary artery (ULMCA) disease. Methods The current study selected 286 patients who underwent PCI for ULMCA lesions in the General Hospital of Shenyang Military Region between Jan. 2007 and Dec. 2008, which included 144 (TRA group) patients with TRA PCI and 142 (TFA group) with TFA PCI for review analysis. Difference in coronary angiography (CAG), operation success rate, implantation of complex bifurcate lesion stent, X-ray exposure period, contrast agent dosage, local vascular complications, major adverse cardiac events (MACE) rate during hospitalization and visiting period, post-PCI ambulation, post-PCI hospitalization period, and the total hospitalization period between the two groups were compared. Results The two groups have similar baseline features. The difference between the TRA and TFA groups in CAG and operation success rate (96. 5% and 98. 6% for TRA and 92. 3% and 97. 9% for TFA, respectively) has no statistical significance (P=0. 116, P=0. 641). The difference between the TRA and TFA groups in terms of implantation rate (29. 9% vs 26. 8%) of complex bifurcate lesion stent (crushed, culotte, T stent), exposure period (53. Lmin±10.42min to 51. 23min±9. 80min), and contrast agent dosage (247.66ml± 106.98ml vs 267.26ml± 136.09ml) has no statistical significance (P=0.561, P=0.105, P=0.175). The TRA group has lower local vascular complications (10. 4% vs 19. 7%) than the TFA group (P=0. 028). MACE during hospitalization in the TRA group (6. 3%) is lower than that in the TFA group (12. 7%), but the difference has no statistical significance (P=0. 066). Neither group has post-PCI myocardial infarction, stroke, or emergency coronary artery bypass grafting. The TRA group has shorter (P<0. 001) post-PCI ambulation period (1. 37days±0. 62days vs 2. 40days±l. 45days), post-PCI hospitalization period (4. 16days±3. 19days -us 7. 75days±5. 29days) and total hospitalization period (7. 29days± 4. 42days us 12. 10days± 7. 58days). During the visiting period of 10months ± 5. 6months at average, the difference in MACE between the two groups (10. 1 % vs 9. 9%, P=0. 953) has no statistical significance. Conclusions The TRA approach has similar success rate and lower rate of complications than the TFA approach for the stent implantations for ULMCA. The TRA approach is safe and feasible and has the same effect as TFA.关键词
无保护左主干/血管成形术,冠脉介入治疗/经桡动脉途径/经股动脉途径Key words
unprotected left main coronanry artery/ angioplasty, transluminal percutaneous coronary/ transradial approach/transfemoral approach分类
医药卫生
