目的:本研究旨在探讨经桡动脉入路血管并发症(VC)的预测因素,因为发现这些并发症的发生率和严重程度明显低于股骨入路。然而,值得注意的是,这些并发症的发生对临床结局仍有负面影响.然而,关于与桡动脉入路相关的并发症预测因素的现有数据有限.
方法:对在大坪医院接受经皮冠状动脉诊断或治疗程序的个体进行了回顾性病例对照研究。遵循纳入和排除标准。这项研究比较了人口统计学特征,VC类型,踝臂指数(ABI),两组冠状动脉狭窄程度。
结果:我们招募了300名具有VC的受试者和300名没有VC的年龄和性别匹配的受试者作为对照。两组之间的基线特征或合并症没有差异。与对照组相比,VC组有较高比例的左桡动脉入路(6.0%)和既往桡动脉穿刺史(29.7%vs.18.3%,p<0.001)。ABI明显低于非VC组(1.17±0.17vs.1.23±0.14,p<0.001)。在多变量逻辑回归分析中,发现几个因素与VC的发生独立相关。这些因素包括ABI(OR=0.060,95%CI:0.014-0.249,p<0.001),由初级操作员执行的程序(OR=1.892,95%CI:1.314-2.745,p<0.001),和先前在同一桡动脉上的通路(OR=1.795,95%CI:1.190-2.707,p<0.01)。
结论:患者表现出较低的ABI,并且有既往放射状入路手术史,其发展为放射状入路VC的风险增加。因此,建议在这些程序之前常规测量ABI,因为它可以作为评估VC风险的预测工具。
OBJECTIVE: The study aimed to explore the predictors of vascular complications (VCs) associated with transradial access, as the occurrence and severity of these complications were found to be significantly lower compared to femoral access. However, it is important to note that the occurrence of these complications still has a negative impact on clinical outcomes. Nevertheless, there is limited available data on the predictors of complications specifically related to radial access.
METHODS: A retrospective case-control study was conducted on individuals who underwent percutaneous coronary diagnostic or therapeutic procedures at Daping Hospital, following the inclusion and exclusion criteria. The study compared demographic characteristics, VC types, ankle brachial index (ABI), and severity of coronary artery stenosis between the two groups.
RESULTS: We enrolled 300 subjects with VCs and 300 age- and sex-matched subjects without VCs as controls. There were no differences in the baseline characteristics or comorbidities between the groups. Compared to the control group, the VC group has a higher portion of left radial access (6.0%) and previous radial artery puncture history (29.7% vs. 18.3%, p<0.001). The ABI was significantly lower than the non-VC group (1.17 ± 0.17 vs. 1.23 ± 0.14, p<0.001). In the multivariate logistic regression analysis, several factors were found to be independently associated with the occurrence of VC. These factors include ABI (OR=0.060, 95% CI: 0.014-0.249, p<0.001), the procedure being performed by junior operators (OR=1.892, 95% CI: 1.314-2.745, p<0.001), and previous access on the same radial artery (OR=1.795, 95% CI: 1.190-2.707, p<0.01).
CONCLUSIONS: Patients who exhibit a lower ABI and have a history of prior radial access procedures may be at an increased risk of developing radial access VC. Therefore, it is recommended to routinely measure ABI prior to these procedures, as it may serve as a predictive tool for assessing the risk of VC.