СРАВНЕНИЕ СТАНДАРТНОГО И ДИСТАЛЬНОГО ЛУЧЕВОГО ДОСТУПА ПРИ ПРОВЕДЕНИИ КОРОНАРОАНГИОГРАФИИ И ЧРЕСКОЖНОГО КОРОНАРНОГО ВМЕШАТЕЛЬСТВА
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.
Литература
Mueller RL, Sanborn TA. The history of interventional cardiology: cardiac catheterization, angioplasty and related minterventions. American Heart Journal. 1995;129(1):146-172. https://doi.org/10.1016/0002-8703(95)90055-1
Amin MR, Singha CK, Banerjee SK, Hoque H, Mahabub SM Ear E, Hoque M, Biswas E. Comparison of Distal Transradial in the Anatomical Snuffbox versus Conventional Transradial Access for Coronary Angiography and Intervention-An Experience in 100 cases. University Heart Journal. 2017;13(2):40-45. https://doi.org/10.3329/uhj.v13i2.37657
Brueck M, Bandorski D, Kramer W, Wieczorek M, Höltgen R, Tillmanns H. A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty. JACC: Cardiovascular Interventions. 2009;2(11):1047-1054. https://doi.org/10.1016/j.jcin.2009.07.016
Cantor WJ, Puley G, Natarajan MK, Dzavik V, Madan M, Fry A, Kim HH, Velianou JL, Pirani N, Strauss BH, Chisholm RJ. Radial versus femoral access for emergent percutaneous coronary intervention with adjunct glycoprotein IIb/IIIa inhibition in acute myocardial infarction - the RADIAL-AMI pilot randomized trial. American Heart Journal. 2005;150(3):543-549. https://doi.org/10.1016/j.ahj.2004.10.043
Dzeshka MS, Brown RA, Capodanno D, Lip GY. Antiplatelet and Antithrombotic Therapy in Patients with Atrial Fibrillation Undergoing Coronary Stenting. Interventional Cardiology Clinics. 2017;6(1):91-117. https://doi.org/10.1016/j.iccl.2016.08.007
Campeau L. Percutaneous radial artery approach for coronary angiography. Catheterization and Cardiovascular Diagnosis. 1989;6(1):3-7. https://doi.org/10.1002/ccd.1810160103
Cooper CJ, El-Shiekh RA, Cohen DJ, Blaesing L, Burket MW, Basu A, Moore JA. Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison. American Heart Journal. 1999;138(3):430-436. https://doi.org/10.1016/S0002-8703(99)70143-2
Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. Journal of the American College of Cardiology. 1997;29(6):1269-1275. https://doi.org/10.1016/S0735-1097(97)00064-8
Mann JT 3rd, Cubeddu MG, Schneider JE, Arrowood M. Right radial access for PTCA: A prospective study demonstrates reduced complications and hospital charges. Journal Invasive Cardiology. 1996;8 Suppl D:40D-44D.
Valsecchi O, Musumeci G, Vassileva A, Tespili M, Guagliumi G, Gavazzi A, Ferrazzi P. Safety, feasibility and efficacy of transradial primary angioplasty in patients with acute myocardial infarction. Italian Heart Journal. 2003;4(5):329-334.
Achenbach S, Ropers D, Kallert L, Turan N, Krähner R, Wolf T, Garlichs C, Flachskampf F, Daniel WG, Ludwig J. Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age. Catheterization and Cardiovascular Interventions. 2008;72(5):629-635. https://doi.org/10.1002/ccd.21696
Archbold RA, Robinson NM, Schilling RJ. Radial artery access for coronary angiography and percutaneous coronary intervention. British Medical Journal. 2004;329(7463):443-446. https://doi.org/10.1136/bmj.329.7463.443
Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal. 2019;40(2):87-165. https://doi.org/10.1093/eurheartj/ehy394
Chase AJ, Fretz EB, Warburton WP, Klinke WP, Carere RG, Pi D, Berry B, Hilton JD. Association of the arterial access site at angioplasty with transfusion and mortality: the MORTAL study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart. 2008;94(8):1019-1025. https://doi.org/10.1136/hrt.2007.136390
Sciahbasi A, Pristipino C, Ambrosio G, Sperduti I, Scabbia EV, Greco C, Ricci R, Ferraiolo G, Di Clemente D, Giombolini C, Lioy E, Tubaro M. Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of Early Invasive and Conservative Treatment in Patients with Non-ST-ElevatiOn Acute. Coronary Syndromes [PRESTO-ACS] Vascular Substudy). American Journal of Cardiology. 2009;103(6):796-800. https://doi.org/10.1016/j.amjcard.2008.11.049
Kiemeneij F. Left distal transradial access in the anatomical snuff-box for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017;13(7):851-857. https://doi.org/10.4244/EIJ-D-17-00079
Doscher W, Viswanathan B, Stein T, Margolis IB. Hemodynamic assessment of the circulation in 200 normal hands. Annals of Surgical. 1983;198(6):776-779. https://doi.org/10.1097/00000658-198312000-00018
Kaledin AL, Kochanov IN, Podmetin PS, Seletskiy SS, Ardeev VN, Garin JuJu, Kozaev AV, Ibragimov IM. Distalnyj otdel luchevoj arterii pri jendovaskuljarnyh vmeshatelstvah. [Distal radial artery in endovascular interventions]. Jendovaskuljarnaja hirurgija [Russian Journal of Endovascular Surgery]. 2017;4(2):125-133. doi: 10.24183/2409-4080-2017-4-2-125-133. (Russian).
Gupta S, Nathan S. Radial artery use and reuse. Cardiac Interventions Today. 2015;9(3):49-56.
McLean KM, Sacks JM, Kuo YR, Wollstein R, Rubin JP, Lee WP. Anatomical landmarks to the superficial and deep palmar arches. Plastic and Reconstructive Surgery. 2008;121(1):181-185. https://doi.org/10.1097/01.prs.0000293863.45614.f9
Koutouzis M, Kontopodis E, Tassopoulos A, Tsiafoutis I, Katsanou K, Rigatou A, Didagelos M, Andreou K, Lazaris E, Oikonomidis N, Maniotis C, Ziakas A. Distal versus traditional radial approach for coronary angiography. Cardiovascular Revascularization Medicine. 2018. https://doi.org/10.1016/j.carrev.2018.09.018
