Clinical Study On The Efficacy And Safety Of Coronary Intervention Via Distal Transradial Artery Access

Objective: To investigate the efficacy and safety of coronary intervention diagnosis and treatment via distal transradial artery access.Methods: A total of 130 patients who underwent coronary angiography(CAG)and/or percutaneous coronary intervention(PCI)in Department of Cardiology of Handan Central Hospital from December 2019 to October 2020 were randomly divided into distal radial artery group(n = 63)and conventional radial artery group(n = 67)according to random number table.Vascular ultrasonography was performed 48 hours before and 48 hours after surgery.The diameter of puncture vessels and endothelium-dependent flow mediated vasodilation(FMD)were recorded and compared respectively before and after surgery.General information,success rate of arterial puncture,number of puncture,puncture time,success rate of one puncture,postoperative compression time of puncture artery,VAS pain score,CAG time,PCI time,amount of heparin,amount of X-ray radiation,postoperative complications were compared between the two groups.Major adverse cardiac events and secondary adverse cardiac events after complex PCI and coronary precision intervention were recorded in both groups.To analyze the effectiveness and safety of distal radial artery approach.Results: There were no significant differences in general information,success rate of arterial puncture,CAG time,PCI time,amount of heparin,amount of X-ray radiation and operative complications between 2 groups(P > 0.05).There were significant differences in puncture time,puncture number,success rate of one puncture,compression time of puncture artery after operation,and VAS pain score 3 h after operation between 2 groups(P < 0.05).Ultrasound examination showed that the diameter of puncture vessels in both groups was dilated after surgery,and there was a significant difference between the two groups before and after surgery(distal radial artery group: P < 0.05;conventional radial artery group: P < 0.05).Postoperative FMD decreased compared with preoperative,with significant difference between preoperative and postoperative(distal radial artery group: P < 0.001 conventional radial artery group:P < 0.001).In the distal radial artery group,8 patients underwent complex PCI and 2patients underwent precision coronary intervention,and 1 minor adverse event occurred after surgery.In the conventional radial artery group,11 patients received complex PCI and 4 patients received precision diagnosis and treatment of coronary arteries.Postoperative adverse cardiac events occurred in 1 major and 1 minor.Conclusions: The distal radial artery into the road as a kind of brand-new piercing into the road in coronary interventional diagnosis and treatment also has the efficacy and safety,can be completed including balloon to kiss,rotary grinding,intravascular ultrasound,coronary blood flow reserve score detection all coronary interventional diagnosis and treatment,operation,and compared with the conventional radial artery approach a postoperative artery oppression hemostasis convenient time short,oppression,reduce patient pain,improve the performer and the advantages of the patients with comfort,and can through preoperative vascular ultrasound to high penetration efficiency and success rate,can be used as a conventional puncture approach is widely used in clinical.Coronary interventional treatment has adverse effect on the endothelial function of puncture vessels in the short term.