桡骨远端干预与近端干预;真的值得吗?

Ç. Sarıkamış, K. Memiç Sancar, A. Birand, T. Aktemur, A. R. Demir, İffet Doğan, Ömer Aydıner, İ. Aktürk
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摘要

目的:经桡动脉远端入路(dTRA)是一种很有前途的技术,可降低桡动脉闭塞和穿刺相关损伤的风险。迄今为止,还没有数据对土耳其人群中的经桡动脉远端入路(dTRA)和经桡动脉近端入路(pTRA)进行比较。因此,研究人员在本研究中旨在比较 dTRA 与传统 pTRA 在冠状动脉手术中的有效性和安全性。研究方法2021 年 9 月至 2022 年 6 月期间,在一家三级心脏中心接受经桡动脉血管造影术的患者被纳入本研究。患者被随机选中使用等量的远端 dTRA 或传统 pTRA 进行冠状动脉成像。共有79名患者被随机分配到近端方法,77名患者被随机分配到dTRA。主要终点定义为手术失败。结果:dTRA 的插管成功率明显低于近端 pTRA(pTRA [89.6%] 和 pTRA [79%] p=0.002)。桡动脉血栓并发症的发生率在两组之间没有差异(近端 10.6% 对远端 5.8%,P=0.288)。与桡动脉近端组(15-30 分钟,中位数 20 分钟)相比,dTRA 组的插管时间和总手术时间更长(20-40 分钟,中位数 25 分钟),P=0.005。不过,这并不影响总的手术时间:3.3 分钟(1.6-6.4)对 2.4 分钟(1.6-3.7)。结论:dTRA 的入路时间相对较长,但在桡动脉血栓并发症方面没有优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distal Versus Proximal Radial Intervention; Is It Really Worth of It?
Objectives: Distal transradial approach (dTRA) is a promising technique with a decreased risk of radial artery occlusion and puncture-related injuries. There has been no data which compare dTRA and proximal transradial approach (pTRA) in Turkish population group, so far. Thus, researchers aimed to compare the efficacy and safety of the dTRA versus the conventional pTRA in coronary procedures in this study. Methods: Between September 2021 and June 2022, patients scheduled for transradial angiography at a tertiary cardiac center were enrolled in this study. Patients were randomly selected to undergo coronary imaging using either the distal dTRA or the conventional pTRA in equal numbers. A total of 79 patients were randomized to the proximal approach, and 77 patients were randomized to the dTRA. The primary endpoint was defined as procedural failure. Results: The success rate of cannulation of the dTRA was significantly lower compared to proximal pTRA (pTRA [89.6%] and pTRA [79%] p=0.002). The rate of radial artery thrombotic complications was not different between groups (proxymal %10.6 vs. distal %5.8, p=0.288). The time of cannulation and total procedural time were longer in the dTRA group (20–40 min, median 25 min) compared to the proximal radial group (15–30 min, median 20 min) p = 0.005. However, this did not affect the total scope time duration 3.3 min. (1.6–6.4) versus 2.4 min (1.6–3.7). Conclusion: dTRA has a relatively long access time with no advantages in terms of thrombotic complications in the radial artery.
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