由于解剖学变异,冠状动脉透过放射性动脉接入的冠状动脉造影具有挑战性:单中心体验
Wissam Harmouch1, Alan Villarreal Rizzo2, Ravi Thakker3
1Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
The American journal of the medical sciences
|May 1, 2025
概括
放射性动脉的解剖学变异在超辐射方法冠状动脉造影过程中很常见. 这些变化增加了对比剂量,光学时间,辐射暴露和程序挑战,尽管主要并发症仍然很少见.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管解剖学 血管解剖学
背景情况:
- 透射方法 (TRA) 越来越多地被偏爱于心脏导管治疗,而不是转移式方法 (TFA),因为并发症率较低.
- 上肢,特别是辐射动脉 (RA),容易发生解剖学变异.
- 了解这些变化对于优化TRA程序至关重要.
研究的目的:
- 通过T.R.A.进行冠状动脉造影的患者的放射性动脉解剖变异的流行情况的调查.
- 评估这些变异与程序结果之间的关联,包括挑战和不良事件.
主要方法:
- 追溯分析926名接受TRA冠状动脉血管造影的患者.
- 对RA血管图进行了检查,以检查解剖学变异.
- 多变量逻辑回归分析了变化和结果之间的关联 (对比剂量,光学时间,辐射暴露,程序性困难,转换为TFA,).
主要成果:
- 观察到高患病率的解剖学变异 (32.3%),包括辐射动脉曲,高分叉,M标志和循环.
- 有变异的患者年龄较大,患超脂血症的可能性更高.
- 解剖学变异与增加的对比剂量,更长的光镜时间,更高的辐射暴露,冠状动脉参与困难以及更高的转化率与TFA显著相关. 女性性别和较小的RA大小与有关.
结论:
- 辐射动脉的解剖学变异很普遍,并对TRA程序产生重大影响.
- 这些变化导致了程序资源 (对比,光学,辐射) 的使用量增加以及技术挑战.
- 尽管面临挑战,但在患有解剖变异的患者中,主要并发症并没有显著增加.
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