- 期刊
Impact of the Transradial Approach to Coronary Angiography or Angioplasty on Radial Artery in Taiwanese Population
經橈動脈冠狀動脈攝影及血管成形術對臺灣人橈動脈的影響
摘要
Background: Transradial approach is accepted as an alternative method for coronary angiography and angioplasty. The body size and radial artery size in Taiwanese patients are thought to be smaller than those of Western populations. This study assessed the transradial approach in Taiwanese patients. Methods: This prospective study enrolled 336 patients who underwent coronary angiography or angioplasty in our hospital during the period from February 2001 to February 2002. Ultrasound examinations were performed 3 times (pre-procedure, early post-procedure, and late post-procedure). The ultrasound examinations included 2-dimensional and Doppler studies. The patients were divided into radial artery occlusion and patent subgroups depending on the ultrasound results after transradial coronary procedure. Results: A transradial approach was used to perform coronary angiography in 176 patients as well as coronary angiography plus angioplasty in 160 patients. The mean radial artery inner diameter (RAID) measured by ultrasound was 2.78±0.40 mm pre-procedure. The RAID in males was larger than in females (2.88±0.39 vs. 2.53±0.32 mm, p＜0.001). There was no significant correlation between RAID and age, height, weight, body mass index, and body surface area. The flow volume in men was larger than in women (0.03±0.01 vs. 0.02±0.01L/min, p＜0.001). Radial artery occlusion developed after transradial approach in 36 patients (10.7%), among which recanalization was observed within 3 months in 26 patients. in patients with occlusion of the radial artery after transradial approach the RAID, RAID/sheath outer diameter ratio, and flow volume were smaller than in the patent patients (p ＜0.001). There was no significant difference in RAID, flow velocity and flow volume between pre-procedural, early post-procedural, and late post-procedural ultrasound examinations in patients who did not develop occlusion. Conclusion: This study found that transradial coronary procedure is a safe and practical alternative approach for Taiwanese patients with a normal Allen test. Ultrasound examination of the radial artery was useful in selecting an access route for coronary procedure, an appropriate size of the sheath, and in the follow-up of vascular complications.
並列摘要
Background: Transradial approach is accepted as an alternative method for coronary angiography and angioplasty. The body size and radial artery size in Taiwanese patients are thought to be smaller than those of Western populations. This study assessed the transradial approach in Taiwanese patients. Methods: This prospective study enrolled 336 patients who underwent coronary angiography or angioplasty in our hospital during the period from February 2001 to February 2002. Ultrasound examinations were performed 3 times (pre-procedure, early post-procedure, and late post-procedure). The ultrasound examinations included 2-dimensional and Doppler studies. The patients were divided into radial artery occlusion and patent subgroups depending on the ultrasound results after transradial coronary procedure. Results: A transradial approach was used to perform coronary angiography in 176 patients as well as coronary angiography plus angioplasty in 160 patients. The mean radial artery inner diameter (RAID) measured by ultrasound was 2.78±0.40 mm pre-procedure. The RAID in males was larger than in females (2.88±0.39 vs. 2.53±0.32 mm, p＜0.001). There was no significant correlation between RAID and age, height, weight, body mass index, and body surface area. The flow volume in men was larger than in women (0.03±0.01 vs. 0.02±0.01L/min, p＜0.001). Radial artery occlusion developed after transradial approach in 36 patients (10.7%), among which recanalization was observed within 3 months in 26 patients. in patients with occlusion of the radial artery after transradial approach the RAID, RAID/sheath outer diameter ratio, and flow volume were smaller than in the patent patients (p ＜0.001). There was no significant difference in RAID, flow velocity and flow volume between pre-procedural, early post-procedural, and late post-procedural ultrasound examinations in patients who did not develop occlusion. Conclusion: This study found that transradial coronary procedure is a safe and practical alternative approach for Taiwanese patients with a normal Allen test. Ultrasound examination of the radial artery was useful in selecting an access route for coronary procedure, an appropriate size of the sheath, and in the follow-up of vascular complications.
延伸閱讀
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