(PPT)-经桡动脉介入诊疗中桡动脉痉挛发生、预防及机制的研究.pptVIP

经桡动脉介入诊疗中桡动脉痉挛发生、预防及机制的研究 Study on the Incidence, Prevention and Mechanism of Radial Artery Spasm during Transradial Procedure Part I: Incidence and Predictors of Radial Artery Spasm during Transradial Coronary Angiography and Intervention Part II: Prospective, Randomized and Double-blind Study on Prevention of Radial Artery Spasm Part III: Matched Case-Control Study on Mechanism of Radial Artery Spasm Objects Radial artery spasm (RAS) is the most common complication in transradial coronary angiography and intervention. In this study, we designed to investigate the incidence of RAS during transradial procedures in Chinese, find out the independent predictors, and analyze the clinical effect of RAS during follow-up. The second part of the study were to compare the preventive effect of verapamil 200μg, verapamil 1mg and a cocktail (verapamil 200μg plus nitroglycerin 200μg), and find out the optimized strategy for the prevention of RAS. This study also preliminarily discussed the relationship between vaso-active substances and RAS, find out the mechanism of RAS, and provide theoretic evidence for the prevention of RAS. Conclusions The overal incidence of RAS is 7.8% and female, small radial artery diameter, diabetes and unsuccessful access at first attempt were the independent predictors of RAS. Routine ultrasonography of forearm arteries before the procedure can exclude severe variation of radial artery, effectively avoid RAS and improve the success rate. In the prevention of RAS, it is suggested to use verapamil 200μg plus nitroglycerin 200μg to prevent RAS in transradial coronary procedure. Among the vaso-active substances, endothelin-1 and norepinephrine were the risk factors of RAS during the procedure. 研 究 背 景 研 究 背 景 Structure of radial arteryType Ⅲ artery Intima: endothelium Media: (500μm) SMC concentric layers Adventitia Vasodilators vs. vasoconstrictors Endothelium Vasodilators: NO, PG, PGI2 Vasoconstrictors: ET-1, TXA2, PG2α Systemic: (catecholamin