ABSTRACT
<p><b>BACKGROUND</b>The radial artery is currently regarded as a useful approach for coronary intervention procedures. Adequate anatomical information of the radial artery should be helpful in performing transradial coronary procedures. Few data about the Chinese population have been obtained in this field. Therefore, we tried to evaluate the incidence and clinical significance of anomalous patterns, and their influence on the intervention procedure.</p><p><b>METHODS</b>In an estimated sample of 3000 cases, radial artery and subclavical artery angiography were performed after insertion of the sheath and coronary angiography (CA). The evaluable data including branch anomaly, tortuosity of the radial artery and procedural characteristics were analyzed. The procedure success was defined as CA or percutaneous coronary intervention (PCI) completed with the initial radial artery approach without changing to other routes.</p><p><b>RESULTS</b>In this study, 1897 cases of CA was undertaken and 1103 cases of CA combined with PCI were performed. The success rate of transradial intervention (TRI) was 96.6% (2899/3000). The approach in 44 cases was changed to the contralateral radial artery and 57 cases were changed to the brachial artery or femoral artery due to failure with the initial radial artery approach. The angiography of the upper limb artery was performed in all cases. Anatomic variations of upper limb arteries were noted in 610 patients (20.3%), which included tortuous configurations of the radial artery (5.0%), hypoplasias (2.2%), radioulnar loop (1.1%), abnormal origin of the radial artery (7.7%), stenosis of radial artery (1.4%), a tortuous configuration of the brachial artery (0.9%), a tortuous configurations of the subclavian artery (1.9%), lusoria subclavian artery (0.1%), and subclavian artery occlusion (0.03%). The procedural success rate in the normal population was higher than in the variation group (97.6% vs 93.0%, P < 0.001). In addition, other procedural outcomes and incidence of complications except radial artery occlusion were also significantly superior to variation group.</p><p><b>CONCLUSIONS</b>Anatomic variations of the radial artery were common, making up an important limitation in the trans-radial approach. Selection of appropriate instruments and understanding some tips and tricks were helpful to overcome the obstacles and effectively reduce the learning curve.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon, Coronary , Methods , Coronary Angiography , Radial Artery , Treatment OutcomeABSTRACT
Objective: To investigate the efficacy, toxicity and long-term outcome of hydroxycomptothecin (HCPT) combined concurrent hyperfractionated radiotherapy for unresectable stage III non-small cell lung cancer (NSCLC). Methods: Sixty patients were enrolled into this study and divied into experimental group (n = 30) and control group (n = 30). The patients in the experimental group were administered HCPT at 10 mg/d in NS 250 mL (iv, daily) on the first 5 days and the last 5 days during radiotherapy. The patients were given concurrent hyperfractionated radiotherapy at 1.2 Gy, twice daily. The total dosage of radiation was 62.4-67.2 Gy. Patients in the control group only received hyperfractionated radiotherapy. The long-term survival rate was estimated by Kaplan-Meier survival curve. Results: Fifty-eight patients finished the trial. The follow-up rate was 96%. The response rate was 80% in the experimental group and 66.7% in the control group, respectively (P > 0.05). There was no significant difference in hematologic and non hematologic toxicities between the two groups (P > 0.05). The predicted 1- and 3-year survival rates were 77.7% and 26.1% for the experimental group and 70.3% and 15.1% for the control group, respectively. There was no significant difference between two groups (P > 0.05). Conclusion: HCPT combined concurrent hyperfractionated radiotherapy has definite effects on unresectable stage III NSCLC. The efficacy of combined therapy is better than hyperfractionated radiotherapy, and but the difference was not significant. The toxicity could be torerated.