Abstract：
OBJECTIVE: Trans-radial access (TRA) is the recommended approach for coronary angiography and percutaneous coronary intervention (PCI). Radial artery occlusion (RAO) is the most common complication. We examined the incidence of RAO by means of duplex ultrasonography (DUSG) and the reverse Barbeau test (RBT), after TRA in a clinical setting using conventional pressure dressings to achieve haemostasis. All radial artery patency examinations were performed by one dedicated nurse after a brief training course, we assessed the feasibility and quality of this routine in regular clinical practice.
RESULTS: In total 97 patients undergoing first-time coronary angiograph and in some cases, PCI via TRA completed the study. Conventional pressure dressing as means of haemostasis was used. Radial artery patency was examined by DUSG and by RBT, before and at follow-up 1 month after the procedure. An inter- and intra-observer validation of the ultrasound measurements was performed before inclusion. Two cases of RAO (2.1%) were discovered following TRA. All RAO cases were detected by both DUSG and the RBT. Results from the inter-observer validation showed no statistically significant discrepancy between an experienced physician and a newly trained nurse operator (P = 0.403). An intraclass correlation coefficient (ICC) was calculated at 0.89 indicating excellent reproducibility.
CONCLUSIONS: In a high-volume TRA centre, we found a low incidence of RAO using conventional pressure dressing as means of haemostasis. The easy-to-use RBT detected all cases of RAO. Following a short course of training, a nurse from the cardiac catheterization laboratory was able to perform high quality DUSG examinations of the radial artery to assess patency.
RESULTS: In total 97 patients undergoing first-time coronary angiograph and in some cases, PCI via TRA completed the study. Conventional pressure dressing as means of haemostasis was used. Radial artery patency was examined by DUSG and by RBT, before and at follow-up 1 month after the procedure. An inter- and intra-observer validation of the ultrasound measurements was performed before inclusion. Two cases of RAO (2.1%) were discovered following TRA. All RAO cases were detected by both DUSG and the RBT. Results from the inter-observer validation showed no statistically significant discrepancy between an experienced physician and a newly trained nurse operator (P = 0.403). An intraclass correlation coefficient (ICC) was calculated at 0.89 indicating excellent reproducibility.
CONCLUSIONS: In a high-volume TRA centre, we found a low incidence of RAO using conventional pressure dressing as means of haemostasis. The easy-to-use RBT detected all cases of RAO. Following a short course of training, a nurse from the cardiac catheterization laboratory was able to perform high quality DUSG examinations of the radial artery to assess patency.
摘要：
目的：经桡动脉途径（TRA）是冠状动脉造影和经皮冠状动脉介入治疗（PCI）的推荐方法。桡动脉闭塞(RAO)是最常见的并发症。我们通过双工超声（DUSG）和反向Barbeau试验（RBT）检查了RAO的发生率，TRA后，在临床上使用常规加压敷料实现止血。所有桡动脉通畅性检查均由一名专职护士在简短的培训课程后进行，我们在常规临床实践中评估了该常规的可行性和质量.
结果：共有97例首次行冠状动脉造影的患者完成了这项研究。使用常规的压力敷料作为止血手段。DUSG和RBT检查桡动脉通畅，手术前和手术后一个月的随访。在纳入之前进行超声测量的观察者间和观察者内验证。TRA后发现2例RAO（2.1％）。DUSG和RBT均检测到所有RAO病例。观察者间验证的结果显示，经验丰富的医生和新培训的护士操作员之间没有统计学上的显着差异（p=0.403）。计算的组内相关系数(ICC)为0.89,表明了优异的再现性。
结论：在高容量的TRA中心，我们检测到使用常规压力敷料作为止血手段的RAO总体发生率较低.易于使用的RBT检测到RAO的所有情况。经过短期的培训，心导管实验室的一名护士能够对桡动脉进行高质量的DUSG检查以评估通畅性.
结果：共有97例首次行冠状动脉造影的患者完成了这项研究。使用常规的压力敷料作为止血手段。DUSG和RBT检查桡动脉通畅，手术前和手术后一个月的随访。在纳入之前进行超声测量的观察者间和观察者内验证。TRA后发现2例RAO（2.1％）。DUSG和RBT均检测到所有RAO病例。观察者间验证的结果显示，经验丰富的医生和新培训的护士操作员之间没有统计学上的显着差异（p=0.403）。计算的组内相关系数(ICC)为0.89,表明了优异的再现性。
结论：在高容量的TRA中心，我们检测到使用常规压力敷料作为止血手段的RAO总体发生率较低.易于使用的RBT检测到RAO的所有情况。经过短期的培训，心导管实验室的一名护士能够对桡动脉进行高质量的DUSG检查以评估通畅性.
