慢性全闭塞中的血管接入部位并发症 皮肤冠状动脉干预 皮肤冠状动脉干预
Michaella Alexandrou1, Dimitrios Strepkos1, Pedro E P Carvalho1
1Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
概括
慢性全封闭性皮肤冠状动脉干预期间血管进入部位的并发症与女性性别,大腿动脉进入和更大的尺寸有关. 这些发现有助于对接受CTO PCI的患者进行风险分层.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 血管接入部位并发症 (VASC) 是慢性全封闭 (CTO) 穿皮冠状动脉干预 (PCI) 期间潜在的不良事件.
- 了解VASC的风险因素对于改善复杂PCI程序中的患者安全至关重要.
研究的目的:
- 在接受CTO PCI的大批患者中,确定与血管接入部位并发症相关的患者和程序特征.
- 在这个高风险患者群体中确定VASC的独立预测因子.
主要方法:
- 分析了CTO PCI患者的多中心注册表.
- 基线人口统计数据,程序细节和VASC结果在患有和没有VASC的患者之间进行了比较.
- 使用多变量逻辑回归来确定VASC的独立预测因子.
主要成果:
- 在16810个CTO PCI中,VASC发生在0.9%的PCI中.
- VASC的独立预测因素包括女性性别 (OR 1.95),大腿接 (OR 2.02),以及更大的体大小 (7-F:OR 2.16; 8-F:OR 2.11).
- 与没有VASC的患者相比,VASC患者的重大心脏不良事件和出血率较高.
结论:
- 女性性别,更喜欢获得大腿部接入,以及使用较大的 (≥7F) 是CTO PCI中VASC的重要风险因素.
- 这些发现可以为程序前风险评估提供信息,并指导访问地点的选择,以尽量减少并发症.
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