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目的 :使用 5F共用型造影导管 (Brachial 4.0cm ,Medtronic公司产品 )经皮穿刺桡动脉行冠状动脉动脉造影术 17例 ,报告结果如下。方法 :17例病人 ,男 14例 ,女 3例。年龄 40 -79岁 (平均 5 1.8± 10 .1岁 )。术前诊断冠心病稳定型心绞痛 12例 ,陈旧性心肌梗死 4例 ,心脏瓣膜病 1例。术前检查Aleen试验均为阳性。局麻下穿刺右侧桡动脉 ,导入细钢丝 ,插入 5F桡动脉鞘 ,动脉鞘内注射硝酸甘油 3 0 0微克 ,肝素 3 0 0 0单位。选用超滑导丝以减少对血管壁的刺激。使用 5F共用型造影导管先行左冠状动脉造影再行右冠状动脉造影 ,以 5F猪尾巴导管行左心室造影。术后即刻拔除动脉鞘管 ,穿刺点加压包扎 6小时。结果 :17例桡动脉穿刺均成功 ,l例因右上肢陈旧性骨折 ,桡动脉走形变异 ,导丝无法通过 ,改经股动脉途径造影。 1例术中推送导管时出现血管痉挛 ,经动脉鞘管注入硝酸甘油 2 0 0微克后痉挛解除。造影结果 :9例冠状动脉正常。 4例单支血管病变 ,2例双支血管病变 ,1例三支血管病变 ,1例前降支中段心肌桥。全部病人术后即下床活动 ,无须卧床休息。无一例桡动脉搏动减弱或消失 ,无手部缺血事件发生。结论 :经皮穿刺桡动脉冠状动脉造影术是一种安全可行的冠状动脉介入诊断新途径 ,具有止血容易 ,术后无须卧床休息 ,
PURPOSE: A total of 17 patients undergoing percutaneous transradial coronary angiography with a 5F common contrast catheter (Brachial 4.0cm, Medtronic) were reported. The results are as follows. Methods: 17 patients, 14 males and 3 females. Aged 40-79 years (mean, 5 1.8 ± 10.1 years). Preoperative diagnosis of coronary heart disease in 12 cases of stable angina, old myocardial infarction in 4 cases, 1 case of valvular heart disease. Preoperative Aleen test were positive. Local anesthesia puncture the right radial artery, into the fine steel wire, insert 5F radial artery sheath, arterial intrathecal nitroglycerin 300 micrograms, 3000 units of heparin. Selection of ultra-smooth guide wire to reduce the stimulation of the vessel wall. Using 5F common angiography catheter before left coronary angiography right coronary angiography, 5F pig tail catheter left ventricular angiography. Immediately after removal of the arterial sheath, puncture pressure bandaging 6 hours. Results: 17 cases of radial artery puncture were successful, l cases due to the old right upper extremity fracture, radial artery deviation, guide wire can not pass, change the femoral artery imaging. 1 case of intraoperative catheter pushes vasospasm, arterial sheath injection of 200 microg nitroglycerin after the lifting of spasm. Angiography results: 9 cases of normal coronary artery. 4 cases of single vessel disease, 2 cases of double vessel disease, 1 case of 3 vessel disease, 1 case of anterior descending artery myocardial bridge. All patients get out of bed after surgery, no bed rest. No case of radial pulse weakened or disappeared, no hand-ischemic events. Conclusion: Radial artery percutaneous coronary angiography is a safe and feasible new method of coronary intervention, with hemostasis easy, no bed rest after surgery,