50例经左桡动脉行冠状动脉连同肾动脉造影

目的探讨经左桡动脉穿刺途径，用JL、JR造影导管行左右冠状动脉连同肾动脉造影的可行性和安全性。方法50例需行冠状动脉造影检查的高血压患者，经皮左桡动脉穿刺，用儿、JR造影导管行左右冠状动脉造影后，再用JR造影导管进行左右肾动脉造影。结果47例成功，2例因造影导管长度不够未能完成肾动脉造影，1例因桡动脉畸形改为股动脉途径完成冠状动脉连同肾动脉造影。50例均无术后并发症。结论经左桡动脉途径用JL、JR造影导管行冠状动脉连同肾动脉造影可行性高，安全有效。     

经桡动脉行冠脉造影不同类型5F造影导管应用比较

目的 比较不同类型5F造影导管在经桡动脉途径行冠脉造影的手术成功率、安全性。方法采用回顾性调查的方法对268例接受经桡动脉途径行冠脉造影患者的临床资料进行分析。结果共用型导管组136例中经桡动脉途径使用共用导管完成左冠状动脉造影133例（97．8％），完成右冠脉造影12.9例（94．9％）；Judkins型导管组132例中经桡动脉途径使用Judikins导管完成左冠状动脉造影121例（91．7％），完成右冠脉造影122例（92．4％）。共用型导管组的造影成功率高于Judkins型导管组（P〈0．05）。共用型导管组冠状动脉造影平均X线透视时间和手术操作时间较judikin型导管组明显减少（P〈0．01）。共用型导管组桡动脉痉挛发生率2．94％，judikins组为9．09％，两组差异有统计学意义（P〈0．01）。结论使用5F共用型导管组经桡动脉行冠脉造影可提高手术操作成功率，缩短手术操作时间及X线透视时间，减少桡动脉痉挛的发生。     

使用5F桡动脉鞘及造影导管经桡/尺动脉径路冠状动脉造影624例体会

目的探讨常规使用5F桡动脉鞘及造影导管经桡/尺动脉径路诊断性冠状动脉造影的可行性及安全性。方法选择我院住院行冠脉造影的连续性患者624例,其中男346例,女278例,年龄33～84岁,临床上均符合冠状动脉造影指征,无禁忌证。使用5F桡动脉专用穿刺鞘组首选穿刺右侧桡动脉,若失败再选择穿刺右尺动脉、左桡动脉或左尺动脉,分别使用5FJudkins型造影导管或左右共用型冠状动脉造影导管行冠状动脉造影。结果619例患者经桡/尺动脉径路成功完成左右冠脉的造影,5例经桡动脉冠脉造影失败而改股动脉径路成功。结论经桡/尺动脉入径使用5F桡动脉鞘及造影导管行冠状动脉造影具有成功率高、创伤小、患者极易接受等优点,值得广泛推广。     

56例经左桡、尺动脉途径行冠状动脉连同肾动脉造影

高血压病为冠心病的主要易患因素之一，临床工作中会遇到大量需同时进行冠状动脉和肾动脉造影的患者。经股动脉途径用Judkin。左右冠状动脉造影导管进行诊断陛冠状动脉造影，并用Judkins右量子状动脉造影导管行左右肾动脉造影，已在临床上得到了广泛的应用。1989年Campeau等1省先报道了经桡动脉途径的心脏导管术，随后这一技术因较股动脉途径术后并发症少，患者更为方便，车临床上得到了广泛的应用。     

经桡动脉途径行选择性肾动脉造影的临床应用

目的：评价经桡动脉途径行选择性肾动脉造影的可行性、安全性及其临床意义。方法：选择2002年7-12月收住院伴有血压升高的疑似冠心病患者124例，按不同的动脉途径分为两组：经桡动脉造影组68例，经股动脉造影组56例，均在冠状动脉造影结束即刻同途径行选择性肾动脉造影，对比观察两组在肾动脉造影期间X光照时间、手术操作时间、手术成功率、并发症发生率。结果：两组共检出肾动脉狭窄18例，肾动脉狭窄总发生率为14．5％。两组在X光照时间、手术操作时间差异无显著性（P＞0．05），经桡动脉造影组手术成功率低于经股动脉造影组（P〈0．05），经桡动脉造影组并发症发生率低于经股动脉造影组（P〈0．05）。结论：在目前经桡动脉行冠状动脉造影逐渐开展的状态下，经同途径行选择性肾动脉造影来确诊肾动脉狭窄患者，具有安全、可行、穿刺部位血管并发症少的优点，并可通过改进导管长度提高手术成功率。     

使用5F和6F造影导管经桡动脉径路行冠状动脉造影的对比研究(摘要)

目的 :随着冠心病介入诊疗技术的普遍开展 ,介入器材的进步 ,各种规格造影导管的使用应予研究。本文旨在探讨常规使用较小直径造影导管经桡动脉径路施行诊断性冠状动脉造影的可行性、安全性及优越性。方法 :选择 2 0 0 0年 12月到 2 0 0 2年 10月我院择期冠状动脉造影患者 14 0例 ,其中男性 12 0例 ,女性 2 0例 ,平均年龄 5 6.2±10 .3岁 (2 4-83岁 )。入选患者术前均行Allen′s试验 ,阳性者 (<10sec)入选。在桡动脉穿刺成功后 ,按其造影时首先选用 6F桡动脉鞘管和 6FJudkins造影导管抑或首先选用 5F或 6F桡动脉鞘管和 5F桡动脉径路专用的供左、右冠状动脉插管的 5F共用型造影导管 (日本Terumo公司生产BrachialType)分为 6FJudkins型导管组—A组 (3 0例 )和 5F共用型导管组—B组 (110例 )。对比观察两组手术成功率、冠状动脉造影X光透视时间、手术操作时间、血管并发症的发生率和使用的导管数。结果 :1、A组 3 0例中 ,2 7例 (其中 1例改为肱动脉径路 ) (90 .0 % )经桡动脉径路行左、右冠状动脉造影成功 ,3例 (10 .0 % )经桡动脉径路仅完成部分操作 (左或右冠状动脉造影 ) ,后改为股动脉径路补充完成全部造影操作。B组 110例中 ,10 6例 (其中 5例改为肱动脉径路 ) (96.4% )经桡动脉径路行左、右冠状动脉     

经桡动脉行冠状动脉造影中共用型导管的应用

近年来，经皮穿刺桡动脉冠状动脉造影术在欧美、日本等国及国内少数医院的开展逐渐增多，成为冠状动脉造影术的主要路径之一。不少文献报道多数经桡动脉路径冠状动脉造影可用Judkins导管完成，而作者尝试使用单根共用型导管完成冠状动脉造影，现将初步经验报告如下。     

经桡动脉冠状动脉造影114例分析

目的探讨经桡动脉路径行冠状动脉造影的可行性、安全性及成功率。器材选择上探讨左右共用型导管的临床可行性。方法回顾性分析我院114例患者经桡动脉路径行冠状动脉造影术的临床资料。结果 114例中92%(105/114)的患者成功经桡动脉路径完成冠状动脉造影术,所有患者无严重并发症发生。左右共用型导管成功率高(85%,82/97),具有临床可行性。结论经桡动脉路径行冠状动脉造影术操作成功率高,临床应用安全。左右共用型导管成功率高,值得临床推广。     

经桡动脉途径行冠状动脉造影和介入治疗的临床应用

目的：总结经桡动脉行冠状动脉造影和介入治疗的经验。方法：对有冠状动脉造影指征的住院患者53例，经桡动脉穿刺实施冠状动脉造影，如有冠状动脉病变则进一步作介入治疗。结果：52例（98．1％）桡动脉穿刺成功并完成冠脉动脉造影，1例患者因桡动脉穿刺失败而改行肱动脉穿刺。造影成功率100％。21例介入治疗的患者均最终成功植入支架。8例在手术过程中出现导丝置入困难，其中4例改用亲水导丝。结论：经桡动脉途径行冠脉诊疗术对操作者有较高要求，但在积累一定经验后能顺利完成。     

经皮桡动脉途径行冠脉造影和介入治疗的临床分析

目的研究经桡动脉途径对患者行冠状动脉造影（CAG）和经皮冠状动脉介入（PCI）治疗的可行性和安全性。方法对本院2006-06～2008-03的经桡动脉途径行冠状动脉造影（CAG）和经皮冠状动脉介入（PCI）治疗200例患者进行临床资料分析。结果经桡动脉穿刺成功196例，成功率为98.0%；桡动脉插管成功194例，成功率为97.0%。46例病人成功经皮桡动脉穿刺行冠状动脉介入治疗。术中、术后并发症：心律失常2例，血管迷走反射2例，桡动脉痉挛12例，术后穿刺部位小血肿6例，前臂肿胀4例，桡动脉搏动减弱5例，未见其他不良并发症。结论经桡动脉途径行CAG和PCI血管穿刺部位并发症少，患者术后体位不受限制，活动不受限制。     

Safety and efficacy of transulnar approach for coronary angiography and intervention

Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention. Methods Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar （TUA） or transradial approach （TRA）. Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events （MACE） as secondary end point was recorded till 30 days follow-up. Results Successful puncture was achieved in 98.3% （118/120） of patients in the TUA group, and in 100% （120/120） of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs.12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively （P=0.949）. No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients. Conclusions The transulnar approach is as safe and effective as the transradial approach for coronary angiography and intervention. It is an attractive opinion for experienced operators who are skilled in this technique, particularly in cases of anatomic variations of the radial artery, radial artery small-caliber or thin radial pulse.     

Safety and efficacy of transulnar approach for coronary angiography and intervention

Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention.Methods Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar (TUA) or transradial approach (TRA). Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events (MACE) as secondary end point was recorded till 30 days follow-up.Results Successful puncture was achieved in 98.3% (118/120) of patients in the TUA group, and in 100% (120/120) of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs. 12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively (P=0.949). No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients.Conclusions The transulnar approach is as safe and effective as the transradial approach for coronary angiography and intervention. It is an attractive opinion for experienced operators who are skilled in this technique, particularly in cases of anatomic variations of the radial artery, radial artery small-caliber or thin radial pulse.     

Safety and efficacy of transulnar approach for coronary angiography and intervention

Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention.Methods Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar (TUA) or transradial approach (TRA). Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events (MACE) as secondary end point was recorded till 30 days follow-up.Results Successful puncture was achieved in 98.3% (118/120) of patients in the TUA group, and in 100% (120/120) of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs. 12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively (P=0.949). No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients.Conclusions The transulnar approach is as safe and effective as the transradial approach for coronary angiography and intervention. It is an attractive opinion for experienced operators who are skilled in this technique, particularly in cases of anatomic variations of the radial artery, radial artery small-caliber or thin radial pulse.     

The feasibility of left radial artery approach for coronary angiography

Objective:To study the feasibility of the left radial approach for coronary angiography. Methods:195 patients diagnosed with coronary atherosclerotic heart disease were randomly divided for coronary angiography(CAG) into a left radial artery approach group(98 cases) and a right radial artery approach group(97 cases) from Jan 2006 to Dec 2006. Selective coronary angiographies were performed with 5F TIG catheters. The time of puncturing, duration under X-ray fluoroscopy and of the operation, successful rates of puncturing and coronary angiography were recorded. Results:There was no difference in the time of puncturing(2.25±1.58 min vs 2.19±1.62 min), duration under X-ray fluoroscopy(3.12±1.53 min vs 3.21±1.49 min) and the duration of the operation(12.87±2.52 min vs 12.98±2.85 min), nor in the success rates of puncturing(95.91% vs 95.87%) and coronary angiography(94.90% vs 94.85%). Conclusion: Coronary angiography can be accomplished via the left radial artery approach, indicating that this is a worthwhile clinical approach.     

经左右桡动脉行冠状动脉造影术效果分析

目的 探讨经左右桡动脉行冠状动脉造影术的临床疗效以及两者之间的差异.方法 回顾性分析2015年1月至2016年6月期间在我院行冠脉造影术的500例患者的临床资料,按照入路分为左侧桡动脉100例及右侧桡动脉组400例,比较两组患者的手术成功率、手术相关指标、导管到位所需时间、并发症种类及发生率.结果 右侧桡动脉组患者的成功率为96.25%,左侧桡动脉组成功率为95.00%,两组成功率比较差异无统计学意义(P>0.05);两组患者的手术时间、X线暴露时间及对比剂量比较差异均无统计学意义(P>0.05);左侧桡动脉组导管到位时间比右侧组患者明显较短,差异有统计学意义(P<0.05);两组患者术后并发症种类主要为导管打结、血管痉挛、局部血肿等,右侧桡动脉术后并发症的发生率(24.5%)明显高于左侧桡动脉(4.0%),差异有统计学意义(P<0.05).结论 经左侧桡动脉冠脉造影及右侧桡动脉冠脉造影均有很高的成功率,并且两侧入路的手术相关指标不存在明显的差异,但左侧入路导管造影到位时间更短,同时左侧桡动脉冠脉造影术可以有效降低术后并发症,值得临床推广.     

经皮桡动脉冠状动脉造影术和介入治疗的临床应用

目的:探讨经皮桡动脉冠状动脉造影和介入治疗的安全性和可行性。方法:121例拟诊冠心病患者术前均接受Allen′s试验检查,选择右侧桡动脉为穿刺径路,使用6F桡动脉专用鞘管,5F桡动脉造影导管和6F指引导管。结果:桡动脉穿刺成功119例,成功率为98.3%;造影成功112例,成功率为92.5%,9例失败,其中7例为老年女性患者;14例行PCI治疗。局部血肿1例(0.9%),术后无桡动脉闭塞、出血、夹层等血管并发症发生。结论:经皮桡动脉冠脉造影术和介入治疗安全、可行,经桡动脉穿刺局部并发症少,病人更乐意接受,值得推广。选择病例时对于身材矮小、桡动脉搏动细弱的老年女性应慎重。     

5FTIG造影管在急诊经桡动脉冠脉造影术中的应用

目的评价5FTIG造影管在急诊经桡动脉行冠状动脉造影术(CAG)中应用的可行性和安全性。方法 2006年6月至2008年2月间,所有接受急诊冠脉造影的患者术前均给予Allen试验检查,阳性患者全部先行右桡动脉穿刺术,观察造影手术成功率以及即时并发症等。结果共有138例患者使用5FTIG造影管经桡动脉行左右冠状动脉造影。造影失败4例,其中右冠脉造影失败2例,左冠脉造影失败1例,1例为肘动脉闭塞。出现前臂血肿3例,右上肢血肿1例且1周后见沿动脉走行瘀斑,未见冠脉气栓、室颤、窦停和冠脉夹层等并发症。结论 5FTIG造影管在急诊经桡动脉行冠状动脉造影术中使用是安全可行的,具有经济、省时、减少气栓发生率的优点。