复杂的高风险穿皮冠状动脉干预类型,趋势和结果根据血管接入地点
Warkaa Shamkhani1,2, Saadiq Moledina1,2, Muhammad Rashid1,2
1Department of Cardiology, Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.
概括
透射接入 (TRA) 现在是复杂,高风险的皮肤冠状动脉干预 (CHiP) 的首要方法. 与TFA相比,TRA与死亡率,主要出血和主要心血管和脑血管不良事件的几率显著降低.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管接入 血管接入
背景情况:
- 辐射接入改善了穿皮冠状动脉干预 (PCI) 的结果.
- 在复杂,高风险的PCI (CHiP) 中辐射接入的作用尚不清楚.
- 本研究研究了访问站点的利用情况和CHiP程序的结果.
研究的目的:
- 基于访问网站的CHiP程序的基线特征,趋势和结果进行比较.
- 在CHiP中评估跨射线接入 (TRA) 与输接入 (TFA) 的安全性和有效性.
- 在CHiP中确定访问站点与不利结果的独立关联.
主要方法:
- 对英国心血管干预协会数据集的回顾性分析.
- 对2006年至2017年间选择性执行的CHiP程序进行比较.
- 统计分析包括对临床和程序特征进行调整和倾向性得分匹配.
主要成果:
- 在137785个CHiP程序中,44.9%使用了超辐射接入 (TRA),从2006年的14.6%增加到2017年的67%.
- 虽然TRA患者年龄较大,并患有更多的并发症,但对许多复杂的CHiP子集来说,TRA是首选的.
- 调整后的分析显示,与TRA相比,TFA与较高的死亡率,严重出血和MACCE相关.
结论:
- 超辐射接入 (TRA) 是CHiP程序的主要网站.
- 与TFA相比,TRA与死亡率,严重出血和MACCE的几率明显较低.
- 这些发现支持对复杂,高风险的PCI越来越多地采用TRA.
相关概念视频
01:26Cardiac Catheterization IV: Nursing Management
46
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
46
01:24Cardiac Catheterization III: Left Heart Catheterization
40
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
40
01:21Cardiac Catheterization II: Right Heart Catheterization
42
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
42
01:27Peripheral Artery Disease III: Interprofessional Care
11
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11
01:27Coronary Artery Disease V: Interprofessional Care
9
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
9
01:28Cardiac Catheterization I: Pre-Procedure Overview
47
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
47