СРАВНЕНИЕ СТАНДАРТНОГО И ДИСТАЛЬНОГО ЛУЧЕВОГО ДОСТУПА ПРИ ПРОВЕДЕНИИ КОРОНАРОАНГИОГРАФИИ И ЧРЕСКОЖНОГО КОРОНАРНОГО ВМЕШАТЕЛЬСТВА



DOI: http://dx.doi.org/10.25298/2221-8785-2019-17-4-468-473


А. А. Черняк (A. A. Chernyak), В. А. Снежицкий (V. A. Snezhitskiy), А. В. Янушко (A. V. Yanushko ), М. С. Дешко (M. S. Dzeshka), А. В. Максимчик (A. V. Maksimchik), А. Г. Воронович (A. G. Voronovich), С. В. Авдейчик (S. V. Avdejchik), Г. П. Габриянчик (G. P. Gabrijanchik), Ф. Г. Гаджиева (F. G. Gadzhieva), Д. С. Ибрахимова (D. S. Ibrahimova)

Аннотация


Цель исследования – обосновать возможность выполнения коронароангиографии (КАГ) и чрескожного коронарного вмешательства (ЧКВ) через дистальный лучевой доступ и оценить его безопасность.
Материал и методы. Исследование состояло из двух этапов. На первом этапе выполнено ультразвуковое измерение внутреннего диаметра лучевой артерии в области стандартной пункционной точки (дистальная треть предплечья – проксимальный доступ) и в области анатомической табакерки (дистальный доступ) у 160 пациентов, с последующим расчетом относительного изменения ее диаметра. На втором этапе, учитывая минимальную разницу диаметра лучевой артерии в двух точках, выполнена КАГ и/или ЧКВ 134 пациентам.
Результаты. Диаметр лучевой артерии в стандартной точке составил 2,3 (2,0-2,6) мм, в дистальной точке – 2,05 (1,8-2,5) мм. Осложнений, связанных с доступом, за время наблюдения не зарегистрировано.
Выводы. Дистальный лучевой доступ для выполнения КАГ и ЧКВ анатомически обоснован и безопасен.

Ключевые слова


лучевой доступ, лучевая артерия, окклюзия лучевой артерии, коронароангиография, чрескожное коронарное вмешательство

Полный текст:

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