冠状动脉扫描的接入部位与导管诱导的冠状动脉剖析之间的关联
Pietro Di Santo1,2,3, Paul W Boland4, Omar Abdel-Razek1,2
1CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
概括
导管诱导的冠状动脉剖析 (CICAD) 是罕见的. 这项研究没有发现访问地点和CICAD风险之间的联系,尽管住院死亡率仍然很高.
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:
- 导管诱导的冠状动脉解剖 (CICAD) 是冠状动脉血管学过程中罕见但严重的并发症.
- 动脉接入部位 (透射式与输血式) 和CICAD发病率之间的关系尚未得到充分证实.
- 假设超辐射接入 (TRA) 可能会增加CICAD风险,因为血管曲和导管设计.
研究的目的:
- 调查动脉接入部位与发生导管诱导冠状动脉剖析 (CICAD) 的风险之间的关联.
- 确定与CICAD相关的患者和程序因素,特别是在不同的访问策略的背景下.
主要方法:
- 2007年4月至2021年12月间连续进行左心导管注射的报告的回顾性审查.
- 包括报告了动脉接入点的病例;排除了缺乏接入信息的病例.
- 详细分析已确定的CICAD病例,包括访问地点,患者人口统计和结果.
主要成果:
- 在89,876项手术中,共发现了142例CICAD病例 (0.16%).
- 没有发现访问地点 (TRA vs. 转门访问 [TFA]) 和整体CICAD风险 (0.18% vs. 0.15%,P = .34) 之间有显著的关联.
- 在TFA占主导地位的时代,TRA与CICAD风险增加有关,但在TRA占主导地位的时代,这种联系消失了. 男性性别和ST升高心肌梗塞是TRA相关CICAD的重要因素.
结论:
- 在15年的时间里,这项研究没有证明与动脉接入部位相关的CICAD风险增加.
- 虽然入口部位可能不是CICAD的主要驱动因素,但ST升高心肌梗塞和男性性别等患者因素起着作用.
- 导管诱导的冠状动脉剖析带有相当大的医院死亡率8.5%.
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