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目的探讨经桡动脉途径进行急性心肌梗塞冠状动脉介入治疗(TRA-AMI PCI)的可行性、安全性。方法对22例发病在12小时内的急性心肌梗塞(AMI)患者行TRA-PCI,记录血管病变情况、TRA-PCI的疗效以及并发症。结果22例AMI患者中,单支病变6例,两支病变8例,三支病变8例;处理IRA病变LAD12例,LCX3例,RCA7例;其中完全闭塞15例,不完全闭塞7例,血管狭窄程度在90～99%。共放置支架24枚。一次桡动穿刺成功率86.7%。TRA-PCI成功率94.4%。术后6-12拔除桡动脉鞘管压包扎,无须停用肝素治疗,也无体位限制。1例出现前臂血肿,经保守治疗后痊愈,无桡动脉闭塞及神经损伤并发症。结论对血流动力学稳定的AMI患者,TRA-PCI治疗具有血管并发症少,且无须中断肝素抗凝治疗的优点,安全可行,可作为AMI急诊介入治疗方法之一。
Objective To investigate the feasibility and safety of transradial approach for the treatment of acute myocardial infarction with coronary artery interventional therapy (TRA-AMI PCI). Methods Twenty-two patients with acute myocardial infarction (AMI) who developed within 12 hours underwent TRA-PCI. The vascular lesions, the efficacy of TRA-PCI, and complications were recorded. Results Among the 22 AMI patients, there were 6 single lesions, 8 lesions of two lesions and 8 lesions of three lesions. There were 12 cases of LAD, 3 cases of LCX and 7 cases of RCA. There were 15 cases of complete occlusion, 7 cases of incomplete occlusion, Stenosis in the 90 ~ 99%. A total of 24 stent placement. A radial puncture success rate of 86.7%. TRA-PCI success rate of 94.4%. Postoperative 6-12 unplug the radial artery sheath pressure dressing, no need to disable the treatment of heparin, no body position restrictions. One case of forearm hematoma, conservative treatment after healed, no radial artery occlusion and nerve injury complications. Conclusions For hemodynamically stable patients with AMI, TRA-PCI has the advantages of less vascular complications and no interruption of heparin anticoagulation therapy, which is safe and feasible and can be used as an interventional therapy for AMI.