Comparison of the effect of percutaneous coronary intervention via radial and femoral arteries in elderly patients with coronary heart disease / 中国基层医药

ABSTRACT

Objective@#To compare the effect of percutaneous coronary intervention(PCI) via radial and femoral arteries in elderly patients with coronary heart disease(CHD).@*Methods@#From March 2015 to March 2017, the clinical data of 167 elderly patients with CHD who underwent PCI in the People's Hospital of Quzhou were retrospectively analyzed.According to the different ways of artery puncture, the patients were divided into radial artery group(102 cases) and femoral artery group(65 cases). The related conditions in terms of preoperation and postoperation, changes of cardiac function before and after operation, and occurrence of complications were compared between the two groups.@*Results@#The catheter insertion time and X-ray exposure time of the radial artery group were significantly longer than those of the femoral artery group[(3.47±1.04)min vs.(2.25±0.83)min, (25.17±8.49)min vs.(19.31±6.31)min, t=7.974, 4.784, all P<0.05]. The time of bed rest in the radial artery group was shorter than that in the femoral artery group[(5.48±1.64)h vs.(20.58±3.45)h, t=38.017, P<0.05]. There were no statistically significant differences in the number of stents, stent diameter, stent length, arterial puncture time, contrast agent dosage, postoperative bedridden time, postoperative hospital stay and surgical success rate between the two groups(t=0.429, 0.313, 0.157, 1.341, 0.762, 0.637, all P>0.05). The LVEF of the two groups increased significantly after PCI compared with before PCI[(49.38±7.36)% vs.(40.95±6.48)%, (49.01±6.93)% vs.(41.21±7.21)%, t=8.682, 6.288, all P<0.05], but the LVESD and LVEDD decreased significantly[(52.17±8.40)mm vs.(48.96±7.22)mm, (51.48±6.95)mm vs.(49.02±6.10)mm, (59.87±6.49)mm vs.(53.13±5.84)mm, (59.12±5.88)mm vs.(52.98±5.32)mm, t=2.927, 2.145, 7.797, 6.243, all P<0.05]. There was no statistically significant difference in cardiac function between the two groups before and after PCI (all P>0.05). The incidence rates of vascular complications, local bleeding and local hematoma in the radial artery group were significantly lower than those in the femoral artery group(7.84% vs.21.54%, 1.96% vs.15.38%, 0.98% vs.16.92%, χ2=6.510, 8.808, 12.834, all P<0.05). There were no statistically significant differences in the incidence rates of cardiovascular events between the two groups during PCI and follow-up(4.90% vs.4.62%, 8.82% vs.10.77%, χ2=0.082, 0.174, all P>0.05).@*Conclusion@#For elderly patients with CHD, transradial and transfemoral PCI have similar short-term and long-term effects, while transradial puncture of patients with local vascular puncture complications significantly can be reduced, but the puncture time and X-ray exposure time significantly increased.