透皮冠状动脉手术的辐射接入交叉和结果:REPEAT研究
Alessandro Sciahbasi1, Ernesto Cristiano2, Enrico Romagnoli3
1Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy.
International journal of cardiology
|June 24, 2025
概括
通过皮肤冠状动脉手术 (PCP) 的透射方法 (TRA) 的交叉率较低,但切换到股骨接触会增加血管和出血并发症,特别是在女性身上.
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:
- 与皮肤穿透冠状动脉手术 (PCP) 期间的膜接入相比,跨射线方法 (TRA) 减少了并发症.
- 然而,TRA的转换率更高,转换为替代的血管接入方法.
- 本研究研究了在TRA故障后接入站点交叉的速度,方向和临床影响.
研究的目的:
- 评估一次性TRA故障后的交叉速度和方向.
- 评估接入站点交叉对血管和出血并发症的临床影响.
- 为了确定TRA交叉的预测因素.
主要方法:
- 需要在10个中心进行交叉治疗的TRA患者的潜在招募 (2022年7月至2025年1月).
- 包括一个对照组成功的TRA程序 (2:1比率).
- 主要终点:交叉组与非交叉组的住院血管并发症和严重出血;进行单变量和多变量分析.
主要成果:
- 在17462名TRA-PCP患者中,有2.6%需要血管交叉;在53%的交叉中,使用大腿部接入.
- 与对照组相比,交叉组的重大出血和血管并发症显著增加 (7%对1%,p < 0.001).
- 在TRA失败后的股骨接入导致的并发症比完全辐射方法 (9%对3%,p<0.001) 更多;女性性别是交叉和并发症的独立预测因素.
结论:
- 在TRA-PCP期间的交叉率很低.
- 接入站点交叉,特别是在大腿部接入处,与血管和出血并发症的增加有关.
- 女性性别被确定为TRA交叉和随后的并发症的预测因素.
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