摘要
Objective Coronary arteriography(CAG)and percutaneous coronary intervention(PCI)are the most effective methods for the treatment of coronary atherosclerotic heart disease(CAD),but radial artery vascular variation,especially the presence of 360° tortuous(annular tortuous)radial artery seriously affects the success rate of trans-radial artery approach(TRA)interventional operation.This article provides a preliminary exploration of CAG and PCI through the annular tortuous radial artery.Methods We retrospectively analyzed 15 patients with annular tortuous right radial artery who successfully completed CAG or PCI by annular tortuous radial artery,and summarized the procedures performed through the annular tortuous radial artery.Results We found that the annular tortuous radial artery could be passed through by the catheter with the assistance of percutaneous transluminal coronary angioplasty(PTCA)guide wire or combined with a diameter of 2.0 mm balloon(6-8 atm dilatation state),and then the PTCA wire and the balloon can be replaced with a coronary angiography guide wire after the catheter passed through annular tortuous radial artery,and finally the annular tortuous radial artery could be straightened by fixing the coronary angiography guide wire and rotating and pulling the catheter.Finally,the catheter could be advanced to the coronary orifice and subsequent CAG or PCI could be performed while the annular tortuous radial artery was kept straightening.Both the left and right coronary arteries could perform coronary intervention using this technique,and there were no complications such as forearm hematoma or vascular rupture after this operation.Conclusions It is possible to successfully complete the coronary interventional therapy through annular tortuous radial artery by using the technique with the help of PTCA wire combined with balloon.
摘要
<p><b>OBJECTIVE</b>To investigate the frequency of aborted AMI and clinical characteristics of the patients received prompt fibrinolytic therapy.</p><p><b>METHODS</b>1120 patients with AMI were divided into two groups, true AMI group and aborted AMI group. Aborted AMI was defined as maximal creatine kinase-MB < or = 2 x upper limit of normal coupled with the presence of resolution of chest pain and 50% of ST-segment deviation within 2 hours after onset of therapy. We compared some characteristic of two groups such as the fibrinolytic time after symptom onset and the frequency of aborted AMI.</p><p><b>RESULTS</b>The reopening ratio of infarct was 80.5%. 7.1% of the patients escaped myocardial necrosis. Aborted AMI was highest frequency within the first hour (22.0%) than other time groups (P < 0.01); There were no significant differences in the frequency of Aborted AMI in UK group, SK group and rt-PA group (7.0%, 6.7%, 7.1%, P > 0.05); The rate of Killip III/IV, major arrhythmias, angina pectoris and mortality at 30 day in aborted AMI patients compared with those who had true AMI was 3.9% versus 17.1%, 18.0% versus 30.0%, 1.3% versus 8.0%, 0 versus 6.0%, respectively (P < 0.01).</p><p><b>CONCLUSION</b>Prompt fibrinolytic therapy improved the likelihood of aborted AMI and clinical outcomes. The frequency of aborted AMI has no relationship with fibrinolytic drug, but closely related to the starting time of treatment from symptom onset.</p>