在左心导管治疗期间进行腹腔镜的频率,用于放射性与大腿部接入
Ilan Merdler1, Brian C Case1, Matteo Cellamare1
1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America.
概括
透皮冠状动脉干预 (PCI) 的放射性动脉接入可能会导致较少的心室内膜扫描和右心导管手术,而不是腿部接入. 然而,这些程序并没有显著影响患者的结果.
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:
- 射线动脉接入是用于左心导管 (LHC) 和穿皮冠状动脉干预 (PCI) 的广泛使用的方法.
- 它的流行源于其易于访问,可压缩性和由于表面血管解剖学的有效血液静止.
研究的目的:
- 为了比较使用腹腔镜和中央静脉接入在通过放射性与大腿动脉接入进行PCI的患者.
- 分析不同急性冠状动脉综合征和稳定性 angina 的程序趋势.
主要方法:
- 在2013年11月至2023年2月期间接受PCI的7714名患者的回顾性分析.
- 患者被分为ST升高心肌梗塞 (STEMI),非ST升高急性冠状动脉综合征 (NSTE-ACS) 和稳定性胸痛组.
- 腹腔镜和中央静脉接入率的比较,在辐射和股骨接入组之间.
主要成果:
- 在STEMI (53.4%对47.5%) 和NSTE-ACS (34.2%对31.8%) 患者的股骨上进的患者中,观察到向更高的腹腔镜率的趋势.
- 在所有诊断中,中央静脉接入与大腿接入明显更常见 (STEMI: 36.2%与7.6%相比; NSTE-ACS: 19.3%与2.8%相比; 稳定性心痛: 26.4%与2.7%相比).
- 操作人员进行了较少的心室内扫描和右心导管 (RHC) 程序与辐射接入.
结论:
- 与大腿门相比,射线动脉接入可能与腹腔镜和RHC的性能降低有关.
- 尽管在执行这些程序时存在差异,但常规腹腔镜和血液动力学评估并没有证明对患者的结果有重大影响.
- 这些发现表明,虽然辐射访问可能会影响程序选择,但既定结果不会受到损害.
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