经绕动脉途径冠心病介入诊治的初步体会.doc

经桡动脉途径外周血管造影的初步体会 方玉强，杨成明，王旭开，曾春雨，王红勇，石伟彬，付春江，张 晔，陈 乔 (第三军医大学大坪医院野战外科研究所心血管内科，重庆 400042) 摘 要：目的 探索经桡动脉途径开展外周血管造影的安全性和有效性。 方法 对180例(男性106例，女性74例)患者进行经桡动脉途径的外周血管造影，其中双侧颈动脉、双侧椎动脉、双侧锁骨下动脉采用5F共用型造影管，部分左侧血管采用猪尾造影管；双肾动脉采用6F猪尾造影管或J6FR4.0造影管。结果 用共用型造影管右侧锁骨下动脉、椎动脉、颈动脉造影成功率均为100%(180/180)，左侧锁骨下动脉、椎动脉、颈动脉成功率均为93.3% (168/180)，其中约6.7%(12/180)需用猪尾造影管造影，双侧肾动脉造影成功率为84.3% (70/83)；造影不成功或显影不佳的主要原因为主动脉弓迂曲，占4.6%(4/83)，或身高＞178cm，占11.1%(9/83)；手术中发生桡动脉痉挛占3.9%(7/180)，术后桡动脉闭塞占2.2%(4/180)，穿刺部位皮下出血为8.3%(15/180)，与术后手部活动少有关。术后无出血、动静脉瘘、假性动脉瘤及皮肤破溃感染发生。结论 经桡动脉途径进行部分外周血管造影是一种安全、有效、易于接受的介入诊治方法。 关键词：经桡动脉途径；外周动脉造影术 中图法分类号： 文献标识码： Experience in transradial Study of Transradial Approach pperipheral arterioangiography FANG Yu-qiang, YANG Cheng-ming，, WANG Xu-kai，, ZHENG Chun-yu, WANG Hong-yong, SHI Wei-bing, FU Chun-jiang，, ZHANG Ye, CHENG Qiao (Department Department of cardiologyCardiology, Institute of Surgery Research, , Daping hospitalHospital, The Third Military Medical University， , Chongqing， 400042, China) Abstract: Objective To evalute the safety and efficacy of peripheral arterio- angiography through transradial artery approach. Methods Totally 180 patients (including 106 males and 74 females) were examined. Results The success rate was 100% of in angiography of subclavian artery, vertebral artery, and carotid artery on the right side, while that was 93.3% (168/180) on the left side. But tThe success rate of angiography was 84.3% (70/83) of for renal artery. and tThe cause of failure reason was the abnormal curvature of aortic arch (4.6%, 4/83) or the body height was above 178 cm (11.1%, 9/83). The perioperative complications were radial arteriospasm 3.9% (3.9%, 7/180), radial arterial occlusion after operation2.2% (2.2%, 4/180), subcutaneous hemorrhage of puncture site 8.3% (8.3%, 15/180). There were no terrible hemorrhage, arterio-venousartery-vein leakagefistula, pseudoaneurysm and or skin infection after operation. Conclusion Transradial approach for peripheral arteri