Quantitative impact of cardiovascular risk factors and vascular closure devices on the femoral artery after repeat cardiac catheterization.
Quantitative impact of cardiovascular risk factors and vascular closure devices on the femoral artery after repeat cardiac catheterization.
复制标题
重复心导管检查后心血管危险因素和血管闭合装置对股动脉的定量影响。
DOI：
10.1016/j.ahj.2009.10.023
复制
发表时间：
2010
影响因子：
4.8
通讯作者：
Resnic,FredericS
中科院分区：
文献类型：
--
作者：
Tiroch,KlausA;Matheny,MichaelE;Resnic,FredericS
背景：我们评估了心导管置入术后重复插管、血管闭合装置和心血管危险因素对股动脉的确切定量长期影响。方法对827名连续患者的2102张可用的股动脉照片进行基于卡尺的定量血管分析。这些患者在2005年1月至2007年4月期间接受了冠状动脉介入治疗，并在2001年12月至2008年1月期间通过同侧股动脉通路至少额外进行了一次插管手术。采用多变量分析控制混杂变量。结果平均被刺动脉直径为6.5±2.1 mm。从第一例到最后一次随访的平均时间为349天。经多因素分析，在指数化操作后，被刺穿的动脉管径没有显著变化(P=.15)，也没有与血管闭合装置的使用有关的变化(P=.25)。较小的动脉与女性(−1.22 mm，P<；0.0001)、血管造影周围血管疾病(PVD，−1.19 mm，P<；.0001)、现在吸烟(−0.48 mm，P=.001)或既往吸烟(−0.23 mm，P=.01)有关，而既往他汀类药物治疗与动脉内径增加(+0.47 mm，P<；.0001)相关。在首次发现PVD之前(P<；.001)，与手工压迫相比，血管闭合装置的使用频率较低。结论血管闭合装置与PVD的动脉大小或进展无关。总体而言，重复插管后血管大小没有随着时间的推移而改变，与现在和以前吸烟相关的血管大小减少，以及以前接受他汀类药物治疗的血管大小增加。
BACKGROUNDWe evaluated the exact quantitative long-term impact of repeated catheterizations, vascular closure devices, and cardiovascular risk factors on the femoral artery after cardiac catheterization.METHODSA total of 2,102 available femoral angiograms from 827 consecutive patients were analyzed using caliper-based quantitative vascular analysis. These patients underwent coronary interventions between January 2005 and April 2007 and had at least one additional catheterization procedure through the ipsilateral femoral access site from December 2001 until January 2008. Multivariate analysis was performed to control for confounding variables. The primary outcome was change in artery size.RESULTSThe average punctured artery diameter was 6.5 ± 2.1 mm. The average time between the first case and last follow-up was 349 days. There was no significant change of the punctured artery size over time after the index procedure (P = .15) and no change associated with the use of vascular closure devices (P = .25) after multivariate analysis. Smaller arteries were associated with female gender (−1.22 mm, P < .0001), presence of angiographic peripheral vascular disease (PVD, −1.19 mm, P < .0001), and current (−0.48 mm, P = .001) or former (−0.23 mm, P = .01) smoking status, whereas previous statin therapy was associated with an increase in artery size (+0.47 mm, P < .0001). Vascular closure devices were used less often compared with manual compression in cases preceding the first detection of angiographic PVD (P < .001).CONCLUSIONVascular closure devices are not associated with a change in the artery size or progression of PVD. Overall, there is no change in vessel size over time after repeat catheterizations, with a decrease in vessel size associated with current and former smoking and an increase with previous statin therapy.