Reduction of bleeding complications on puncture site after percutaneous coronary intervention using a 6.5-French sheathless guiding catheter
Reduction of bleeding complications on puncture site after percutaneous coronary intervention using a 6.5-French sheathless guiding catheter
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使用6.5-French无鞘引导导管减少经皮冠状动脉介入治疗后穿刺部位出血并发症
DOI：
10.1007/s00380-021-02005-8
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发表时间：
2022
影响因子：
1.5
通讯作者：
Akioka Hidefumi
中科院分区：
文献类型：
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作者：
Eun Jeong Park;Eiji Kawamoto;Motomu Shimaoka;Akioka Hidefumi
背景减少经皮冠状动脉介入治疗（PCI）后穿刺部位的并发症非常重要。6.5 Fr无鞘导引导管（GC）的直径比6 Fr传统鞘管小约2 Fr。在本研究中，我们调查了每个性别的经桡动脉途径的PCI后穿刺部位并发症，同时使用6.5 Fr无鞘GC.Methods和resultsOur研究包括332例在2017年8月至2019年7月期间接受经桡动脉冠状动脉介入治疗（TRI）的患者。我们将患者分为6.5 Fr无鞘管GC（Asahi，Intecc，Aichi，Japan）组（无鞘管组：n= 182例男性，58例女性）或6 Fr有鞘管GC组（有鞘管组：n= 150例男性，36例女性）。我们确定了穿刺部位的并发症：渗血、皮下出血、血肿形成、假性动脉瘤和周围神经病变。无鞘管GC组患者的体重指数大于鞘管GC组（24.5 ± 3.5 kg/m2 vs. 23.6± 3.7 kg/m2，p= 0.02）。在男性中，无鞘管GC组和带鞘管GC组穿刺部位并发症发生率无显著差异（19.3% vs. 18.6%，p = 0.88）。然而，女性穿刺部位的并发症发生率在带鞘GC组中高于无鞘GC组（36% vs. 15.5%，p = 0.02）。多元Logistic回归分析显示，使用6.5 Fr无鞘GC独立减少女性患者的并发症（p= 0.006）。ConclusionThe使用6.5 Fr无鞘GC系统在经桡动脉途径减少了女性患者穿刺部位的并发症。与传统鞘管系统相比，6.5 Fr无鞘管GC系统可能是他们的安全选择。
BackgroundReducing complications at the puncture site after percutaneous coronary intervention (PCI) is important. The diameter of a 6.5-French (Fr) sheathless guiding catheter (GC) is smaller by approximately 2-Fr compared to a 6-Fr conventional sheath. In the present study, we investigated the post-PCI puncture site complications of a transradial approach in each gender while using a 6.5-Fr sheathless GC.Methods and resultsOur study consisted of 332 patients who underwent transradial coronary intervention (TRI) between August 2017 and July 2019. We classified the patients into either the 6.5-Fr sheathless GC (Asahi, Intecc, Aichi, Japan) Group (Sheathless group:n= 182 males, 58 females) or the 6-Fr sheathed GC Group (Sheathed group:n= 150 males, 36 females). We determined the complications at the puncture site: oozing, subcutaneous hemorrhage, formation of hematoma, pseudoaneurysms, and peripheral neuropathy. The body mass index of the patients was greater in the sheathless GC group compared to the sheathed GC group (24.5 ± 3.5 kg/m2vs. 23.6 ± 3.7 kg/m2,p= 0.02). In males, there was no significant difference in the complication rate at the puncture site between the sheathless GC and sheathed GC groups (19.3% vs. 18.6%,p= 0.88). However, the complication rate at the puncture site in females was higher in the sheathed GC group than in the sheathless GC group (36% vs. 15.5%,p= 0.02). A multiple logistic regression analysis revealed that the use of a 6.5-Fr sheathless GC independently reduced the complications in female patients (p= 0.006).ConclusionThe use of the 6.5-Fr sheathless GC system in a transradial approach reduced the complications at the puncture site in female patients. The 6.5-Fr sheathless GC system may be a safe option for them compared to the conventional sheath system.