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经皮绕动脉入路并发症:出血

时间:2022-01-12 22:34来源:www.ynjr.net 作者:杨宁介入医学网
经皮桡动脉入路出血并发症包括穿刺部位出血和导管路径出血 在讨论经桡动脉路径穿刺的几个焦点问题中,出血是一个重点问题 优点 缺点 improvedpatientcomfort-Earlyambulation reducedbleedingrisk Noninferiorityresults Re-use? strokerisk long-termconse

经皮桡动脉入路出血并发症包括穿刺部位出血和导管路径出血

在讨论经桡动脉路径穿刺的几个焦点问题中,出血是一个重点问题



优点

缺点

improved patient comfort -Early ambulation

reduced bleeding risk

Non inferiority results

Re-use?

stroke risk ×

long-term consequence to radial artery(re-access or for use as bypass graft)unknown?×

greater radiation exposure to operator ×










RIFLE (Radial Versus Femoral Randomized)
 
RCT with 1001 pts. with acute coronary syndrome undergoing
primary/rescue percutaneous coronary intervention
 
出血并发症发生率低 Lower rate of bleeding complication:
7.8% (桡动脉) vs. 12.2% (股动脉) p=0.026

 
RIFLE-STEACS的结果清楚地显示了STEACS患者在桡动脉入路比股动脉入路方面的优势。这种显著性差异和高成功率应该是使用桡动脉入路治疗急性患者的主要原因。



Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX)
  • RCT with 8404 pts. with acute coronary syndrome undergoing percutaneous coronary intervention
  • Lower rate of major bleeding (unrelated to coronary artery bypass graft):
            1.6% vs 2.3%, RR 0.67, 95% CI 0.49–0.92; p=0.013

 

 

Since 2007 radial access has grown 25% per year in the UK, accounting for > 65% of all PCI’s in 2012

经桡动脉介入放射学应用首次报告



Technical success 98.2%: cross-over to femoral 1.8%

 
  • Complications:
 
                    pseudoaneurysm (n=1)
 
                    hematoma/bleeding (n=13)
 
                    radial artery occlusion (n=11): all asymptomatic
 

 

 

Conclusions: TRA was safe and well tolerated in a heterogeneous patient population across a range of peripheral vascular interventions.


 

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