不同路径行冠脉造影及介入治疗的研究进展

蕊 杨(内蒙古医科大学，中国)
喜 刘(内蒙古自治区人民医院心血管内科，中国)

摘要

在过去的几十年中，心血管疾病的发病率迅速而持续地上升，在全世界造成了巨大的疾病负担。其中，由ST段抬高心肌梗死（ST-Segment Elevation Myocardial Infarction，STEMI）、非ST段抬高心肌梗死（Non-ST-Segment Elevation Myocardial Infarction，NSTEMI）和不稳定型心绞痛组成的急性冠脉综合征（Acute Coronary Syndrome，ACS）几乎占心血管疾病总死亡率的一半。在所有ACS中，STEMI作为一种高风险急症，仍然是发病率最高的原因。冠状动脉造影（Coronary Angiography，CAG）和经皮冠状动脉介入治疗（Percutaneous Coronary Intervention，PCI）是诊断和治疗冠心病的重要手段。CAG和PCI的通路（入路）包括股动脉、桡动脉、肱动脉和尺动脉。由此本文展开综述，对不同穿刺途径行CAG及PCI的优缺点进行分析比较。

关键词

冠状动脉造影；经皮冠状动脉介入治疗；冠状动脉粥样硬化性心脏病；穿刺路径

参考

Joshi R, Alim M, Kengne AP, et al. Task shifting for non-communicable disease management in low and middle income countries-a systematic Review[J]. Plos One, 2014(9):e103754.

Turpie A G. Burden of disease: medical and economic impact of acute coronary syndromes[J]. Am J Manag Care, 2006(12):S430-434.

Montalescot G, Dallongeville J, Van Belle E, et al. STEMI and NSTEMI: are they so different? 1 year outcomes in acute myocardial infarction as defined by the ESC/ACC definition (the OPERA registry)[J]. Eur Heart J, 2007(28):1409-1417.

Dai X, Kaul PJr, SS, et al. Predictors, treatment, and outcomes of STEMI occurring in hospitalized patients[J]. Nat Rev Cardiol, 2016(13):148-154.

Thiele H, Desch S, de Waha S. Acute myocardial infarction in patients with ST-segment elevation myocardial infarction: ESC guidelines 2017[J].Herz, 2017(42):728-738.

赵皎皎,郭兵妹,刘聪聪,等.稳定性冠心病患者对经皮冠状动脉介入术获益的预期现状及其影响因素的研究[J].中华护理杂志,2017,52(2):144-149.

王波,王临池,赵翼洪,等.2009—2013年苏州20岁及以上居民冠心病发病率变化趋势及类型分析[J].中国全科医学,2015,18(24):2952-2956.

范书华.不同入路冠状动脉造影治疗冠心病临床疗效对比[J].实用中西医结合临床,2020,20(13):127-128.

Bertrand OF, Rao SV, Pancholy S, et al. Transradial approach for coronary angiography and interventions: results of thefirst international transradial practice survey[J]. JACC Cardiovasc Inte, 2010(3):1022-1031.

Amoroso G, Kiemeneij F. Transradial access for primary percutaneous coronary intervention: the next standard of care?[J]. Heart,2010,96(17):1341-1344.

马颖艳,韩雅玲,荆全民,等.老年高血压患者介入诊断与治疗术后外周血管并发症56例分析[J].临床军医杂志,2008(2):214-216.

Campeau L. Percutaneous radial artery approach for coronary angiography[J]. Catheterization and ardiovasculardiagnosis,1989,16(1):3-7.

Kiemeneij F, Laarman G J. Percutaneous transradial artery approach for coronary stent implantation[J]. Catheterization and cardiovascular diagnosis,1993,30(2):173-178.

Rashid M, Kwok CS, Pancholy S, et al. Radial artery occlusion after Transradial interventions: a systematic review and meta-analysis[J]. J Am Heart Assoc, 2016,5(1):e002686.

Mizuguchi Y, Izumikawa T, Hashimoto S, et al. Efficacy and safety of the distal transradial approach in coronary angiography and percutaneous coronary intervention: a Japanese multicenter experience[J]. Cardiovascular intervention and therapeutics, 2019,35.

Kaledin A, Kochanov I, Podmetin P, et al. Distal radial artery in endovascular interventions[J]. 2017.

Babunashvili A. TCT-810 NOVEL DISTAL TRANSRADIAL APPROACH FOR CORONARY AND PERIPHERAL INTERVENTIONS[J]. Journal of the American College of Cardiology, 2018,72(13):B323.

Flores EA. Making the right move: use of the distal radial artery access in the hand for coronary angiography and percutaneous coronary interventions[J]. Cath Lab Digest, 2018,26(12):16-25.

Roghani-Dehkordi F, Hashemifard O, Sadeghi M, et al. Distal accesses in the hand (two novel techniques) for percutaneous coronary angiography and intervention[J]. ARYA Atheroscler, 2018,14(2):95-100.

Sadaka MA, Etman W, Ahmed W, et al. Incidence and predictors of radial artery occlusion after transradial coronary catheterization[J]. Egypt Heart J, 2019,71(1):12.

Aoi S, Htun WW, Freeo S, et al. Distal transradial artery access in the anatomical snuffbox for coronary angiography as an alternative access site for faster hemostasis[J].Catheter Cardiovasc Inte, 2019,94(5):651-657.

Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI)[J]. Eurointervention, 2017,13(7):851-857.

Lee JW, Park SW, Son JW, et al. Real-world experience of the left distal transradial approach for coronary angiography and percutaneous coronary intervention: a prospective observational study (LeDRA)[J]. Eurontervention, 2018,14(9):e995-e1003.

Gasparini GL, Garbo R, Gagnor A, et al. First prospective multicentre experience with left distal transradial approach for coronary chronic total occlusion interventions using a 7 Fr Glidesheath Slender[J]. Eurointervention, 2019,15(1):126-128.

Moriyama S, Tagaito S, Mizuguchi Y, et al. Impact of the Distal Radial Artery Approach for Diagnostic Coronary Catheterization in Nursing Service[J]. J Am Coll Cardiol, 2019,74(13):778-794.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v5i6.11898