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目的 :分析经桡动脉冠状动脉造影操作失败和产生并发症的原因。方法 :回顾 2 0 0 0年 12月至 2 0 0 3年 7月我院 3 0 98例准备进行冠状动脉造影的患者 ,其中 3 0 0 5例穿刺成功经验介绍。记录临床和造影过程失败以及并发症的原因。结果 :97% ( 3 0 0 5 /3 0 98)穿刺成功。 1 9% ( 5 6/3 0 0 5 )因为右桡动脉、肱动脉、腋动脉、锁骨下动脉以及无名动脉闭塞迂曲无法把导管送入升主动脉。 4% ( 13 4/3 0 0 5 )因为桡动脉痉挛改为股动脉 ,其中女性占 8 1% ,男性占 3 6%。1 2 % ( 3 7/3 0 0 5 )因主动脉根部扩张、严重主动脉瓣狭窄或关闭不全、冠状动脉起源异常而无法经桡动脉完成冠状动脉造影。并发症 :前臂张力性血肿占 0 5 % ( 16/3 0 0 5 ) ;鞘管或导管拔出困难占 0 2 7% ( 8/3 0 0 5 ) ;右桡动脉急性血栓 0 1%( 3 /3 0 0 5 )。升主动脉夹层、假性动脉瘤、动静脉瘘各占 0 0 3 % (均为 1/3 0 0 5 )。结论 :右桡动脉内反复导管操作易发生痉挛。老年人合并高血压患者血管迂曲常常造成操作困难。右桡动脉造影极少有严重并发症 ,局部并发症发生率低
Objective: To analyze the causes of failure and complications of transradial coronary angiography. Methods: From December 2000 to July 2003, a total of 3 098 patients undergoing coronary angiography in our hospital were retrospectively reviewed. Among them, 3 0 0 5 cases of successful puncture were introduced. Record the failure of the clinical and radiographic procedures and the causes of complications. Results: 97% (3 0 0/3 0 98) puncture success. 19% (56/3005) Because the right radial artery, brachial artery, axillary artery, subclavian artery and unnamed artery occlusion tortuous catheter can not be sent to the ascending aorta. 4% (13 4/3 0 0 5) because of radial artery spasm into the femoral artery, of which 81% of women and 36% of men. 1 2% (3 7/3 0 0 5) due to aortic root dilatation, severe aortic stenosis or insufficiency, abnormal coronary origin and coronary artery can not be completed by radial artery angiography. Complications: Tension hematoma of the forearm accounted for 0 5% (16/3 0 0 5), difficulties of pulling out of the sheath or duct were 0 27% (8/3 0 0 5), acute radial thrombus 0 1% 3/3 0 0 5). Ascending aortic dissection, pseudoaneurysm, arteriovenous fistula accounted for 0 0 3% (all 1 030). Conclusion: Repeated catheterization in the right radial artery is prone to spasm. Vascular tortuosity in elderly patients with hypertension often causes operational difficulties. Right radial artery angiography rarely serious complications, the incidence of local complications is low