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Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel airinflation technique

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World Journal of Cardiology 2017年第11期9卷 807-812页

作者： Victor Voon Muhammad Ayyaz Ul Haq Ciara Cahill Kirsten Mannix Catriona Ahern Terence Hennessy Samer Arnous Thomas Kiernan Cardiology Department University Hospital LimerickDooradoyleLimerickIreland

AIM To compare post-percutaneous coronary intervention(PCI) radial artery occlusion(RAO) incidence between two conventional radial artery compression devices using a novel air-inflation *** One hundred consecutive patients post-PCI were randomized 1:1 to Safeguard or TR band compression devices. Post-radial sheath removal, each compression device was inflated with additional 2 m L of air above index bleeding point during air-filled device application and gradually down-titrated accordingly. RAO was defined as absence of Doppler flow signal performed at 24 h and at 6 wk post-PCI. Patients with missing data were excluded. Statistical significance was defined as P radial sheath inserted. No significant differences were observed between Safeguard radial(n = 42) vs TR band(n = 42) in terms of age(63 ± 11 years vs 67 ± 11 years), clinical presentation(electives, n = 18 vs n = 16; acute coronary syndrome, n = 24 vs n = 26) and total procedural heparin(7778 ± 2704 IU vs 7825 ± 2450 IU). RAO incidence was not significantly different between groups at 24 h(2% vs 0%, P = 0.32) and 6 wk(0%, both).CONCLUSION Safeguard radial and TR band did not demonstrate significant between-group differences in short-term RAO incidence. Lack of evidence of RAO in all postPCI patients at 6 wk follow-up, regardless of radial compression device indicate advantage of using the novel and pragmatic air-inflation technique. Further work is required to more accurately confirm these findings.

关键词： radial artery Arterial occlusive disease Cardiac catheterization

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The Effects of Different Type Vasodilator Agents on radial artery Blood Flow: A Placebo-Controlled Clinical Study

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World Journal of Cardiovascular Diseases 2014年第6期4卷 299-304页

作者： Ahmet Feyzi Abacilar Ugur Cetingok Mehmet Besir Akpınar Omer Faruk Dogan The Department of Cardiovascular Surgery Izmir Sifa UniversityBornova Education and Training HospitalIzmirTurkey Kudret International Hospital AnkaraTurkey The Department of Cardiovascular Surgery Adana Numune Education and Training HospitalAdanaTurkey

Background: The radial artery (RA) is being used as a second arterial conduit in coronary artery bypass grafting (CABG) patients. Vasospasm during the harvesting is the most common problem, yet. Our goal of this research is to evaluate the effects of different vasodilators on RA blood flow. Material and Method: In our 250 CABG patients who were included into the study, patients were divided into five groups which have the same number of the patients. Before the harvesting of the RA, Allen test and modified Allen test were performed. In group 1, sodium nitroprusside (SNP) was administered via central line. In group 2, nitrogliceryne was applied as a vasodilator agent. In group 3, diltiazem as a calcium channel blocker was used. In group 4, dobutamine was used with a dose of 3micro./kg/min. In the remaining patients, as a control group (CG), normal saline solution was used with the same protocol. RA length and radial artery flow, mean arterial blood pressure, central venous pressure, and heart rate were measured before and 10 minutes after drug administration. Results: No significant differences were found between the groups in respect to age, body surface area, cardiopulmonary bypass time, aortic cross clamp time. A multivariate general linear model was created and revealed the drug (specifically SNP and nitroglycerin) as a predictor to increase flow in the radial artery (p = 0.001 and p = 0.002), respectively. SNP has significantly decreased mean arterial pressure when we compared to nitroglycerin (p 0.05). Conclusions: Our study showed that SNP and nitroglycerin are very effective agents to provide the increasing of RA blood flow. However, statistical comparisons exhibited that intravenous SNP was a very effective vasodilating agent for RA than nitroglycerin.

关键词： radial artery Vasospasm Coronary artery Bypass Surgery

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Postoperative Complications and Patient＇s Satisfaction after Harvesting of the radial artery for Coronary artery Bypass

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Journal of Pharmacy and Pharmacology 2018年第3期6卷 217-224页

作者： Aleksandar V. Milutinovic Miodrag S. Peric Andja M. Cirkovic Petar M. Vukovic Predrag S. Milojevic Institute of Cardiovascular Diseases "Dedinje" Belgrade 11 000 Serbia Department for Medical Statistics and Informatics Faculty of Medicine University of Belgrade Belgrade 11 000 Serbia

Objectives： There is a paucity of data regarding wound-site complications and patient＇s satisfaction after harvesting of a radial artery. This study is conducted to evaluate the frequency complications and the level of patient＇s satisfaction after myocardial revascularization in our setting. Methods： From April 2009 to October 2013, 97 patients had radial artery （RA） used as a graft in myocardial revascularization. The graft was harvested using open technique. This was retrospective study. Telephone questionnaire was used to evaluate： arm pain, swelling, mobility, sensory changes, patient＇s contentment with a cosmetic result and the general health state. Results： Pain of limited duration was reported by 24 patients （24.7%）, none of them reported permanent pain. Some problems in performing everyday＇s activities were reported by 8 pts （8.2%）. Sensory changes were permanently present in 5 pts （5.2%）, and frequent arm fatigue was reported by 4 pts （4.1%）. Positive opinion regarding the cosmetic result was reported by 95 pts （97.9%）. State of the health after surgery, 81 pts （83.5%） described as excellent or good. Patients who had more mobility problems, also had more sensory and neurological discomfort respectively. Patients with better self-reported general health state were also more satisfied with the esthetic effect of the intervention. Conclusions： Using the open technique resulted in excellent cosmetic effect. This gives us credit to point out that exclusive need of the endoscopic as a supreme method might be under the question mark. Our study suggests that individual attitude of the particular patient plays extremely important role in his/her overall satisfaction with the end effect of the procedure.

关键词： Coronary artery bypass radial artery vascular grafting quality of life

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Discrepancy of blood pressure between the brachial artery and radial artery

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World Journal of Emergency Medicine 2013年第4期4卷 294-297页

作者： Wen-yuan Li Xiao-hai Wang Li-chong Lu Hao Li Department of Anesthesiology Second Affiliated Hospital of Nanjing Medical University Department of Anesthesiology Affiliated Drum-Tower Hospital of Medical College of Nanjing University Department of Cardio-Thoracic Surgery Affiliated Drum-Tower Hospital of Medical College of Nanjing University Department of Anesthesiology First People's Hospital of Yancheng

BACKGROUND:In this study,we attempted to find the relations between blood pressure(BP)measured on the brachial artery(bBP) and BP assessed on the radial artery(rBP) in the right ***:Three hundred and fifteen patients were enrolled in this *** who had peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were *** a 15-minute equilibration and stabilization period after inducation of anesthesia,three bBP and rBP records were obtained sequentially using an oscillometric device with an adult cuff and infant cuff,*** for each BP was ***:The bBP was significantly lower than the rBP(P<0.05).The difference between the two values varied from 13 to 18 mmHg in systolic BP(SBP),diastolic BP(DBP) and mean blood pressure(MAP) *** the rBP was positively correlated with the bBP(r=0.872,0.754,0.765;P<0.001,<0.001,<0.001;SBP,DBP,MAP,respectively).CONCLUSION:The bBP value can be evaluated by the noninvasive measurements of rBP using an appropriate cuff in clinical practice.

关键词： Blood pressure Brachial artery radial artery Correlation Linear regression

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Efficacy and safety of distal radial approach for cardiac catheterization: A systematic review and meta-analysis

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World Journal of Cardiology 2021年第5期13卷 144-154页

作者： Toshihide Izumida Jun Watanabe Ryo Yoshida Kazuhiko Kotani Division of Community Medicine Kanazawa Medical University Himi Municipal HospitalHimi 935-8531ToyamaJapan Center for Community Medicine Jichi Medical UniversityShimotsuke-City 329-0498TochigiJapan Department of Internal Medicine Iwami HospitalIwami-Town 681-0003TottoriJapan

BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for *** To assess the efficacy and safety of the DRA vs RA during *** The following databases were searched through December 2020:MEDLINE,the Cochrane Central Register of Controlled Trials,EMBASE,the World Health Organization International Clinical Trials Platform Search Portal,and *** randomized-controlled trials for adult patients undergoing cardiac catheterization were *** primary outcomes were the successful cannulation rate and the incidence of radial artery spasm(RAS)and radial artery occlusion(RAO).Study selection,data abstraction and quality assessment were independently performed using the Grading of Recommendations,Assessment,Development,and Evaluation *** Three randomized control trials and 13 registered trials were *** two approaches showed similar successful cannulation rates[risk ratio(RR)0.90,95%confidence interval(CI):0.72-1.13].The DRA did not decrease RAS(RR 0.43,95%CI:0.08-2.49)and RAO(RR 0.48,95%CI:0.18-1.29).Patients with the DRA had a shorter hemostasis time in comparison to those with the RA(mean difference-6.64,95%CI:-10.37 to-2.90).The evidence of certainty was *** For CAG,the DRA would be safer than the RA with comparable cannulation *** the limited data,additional research,including studies with standard protocols,is necessary.

关键词： radial artery Cardiac catheterization Coronary angiography Snuff box Systematic review Meta-analysis

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Effect of tirofiban plus clopidogrel and aspirin on primary percutaneous coronary intervention via transradial approach in patients with acute myocardial infarction

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Chinese Medical Journal 2008年第6期121卷 522-527页

作者： FU Xiang-hua HAO Qing-qing JIA Xin-wei FAN Wei-ze GU Xin-shun WU Wei-li HAO Guo-zhen LI Shi-qiang JIANG Yun-fa GENG Wei Department of Cardiology Second Hospital of Hebei MedicalUniversity Shijiazhuang Hebei 050000 China

Background Aspirin and clopidogrel can improve myocardial reperfusion and alleviate myocardial injury during percutaneous coronary intervention （PCI）. Whether the addition of intravenous tirofiban during this procedure produces further benefit has not been clarified in ST segment elevation myocardial infarction （STEMI） patients. We evaluated this on STEMI patients who underwent primary PCI （p-PCI） via transradial artery approach. Methods Consecutive patients were randomized into tirofiban group （n=-72） or placebo group （n=-78）. Angiographic analysis included initial and final thrombolysis in myocardial infarction （TIMI） flow grade （TFG）, corrected TIMI frame count （CTFC） and TIMI myocardial perfusion grade （TMPG） of the thrombotic vessel. Platelet aggregation rate （PAR）, creatine phosphokinase （CPK）, CPK isoenzyme MB （CPK-MB） and troponin I levels were measured and TIMI definitions were used to assess bleeding complications. Left ventricular performance parameters were investigated with equilibrium radionuclide ventriculography. Major adverse cardiac events （MACE） were followed up for 6 months. Results The cases of TFG 0 and 1 before PCI, TFG 0 when first crossing of guide wire were less, and the cases of TFG 3 after PCI was more in tirofiban group than those in placebo group. The final CTFC was fewer and the incidence of no reflow phenomenon was lower, as well the percentage of final TFG 3 was higher in tirofiban group than those in placebo group （all P 〈0.05）. Mean peak CPK-MB was significantly lower, while the left ventricular performance parameters 1 week after PCI were much more improved in tirofiban group than those in the placebo group. PAR was significantly decreased shortly after tirofiban infusion. The incidence of 6-month MACE in tirofiban group was obviously lower than that in the placebo group. No statistical difference was noted between the two groups with regard to bleeding complications. Conclusions Intravenous tirofiban infusion, in addition to aspi

关键词： myocardial infarction tirofiban percutaneous coronary intervention platelet aggregation radial artery

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Comparative study of 4Fr catheters using the ACIST variable rate injector system versus 6Fr catheters using hand manifold in diagnostic coronary angiography via transradial approach

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Chinese Medical Journal 2010年第11期123卷 1373-1376页

作者： HOU Lei WEI Yi-dong SONG Jing CHE Wen-liang PENG Wen-hui WANG Yong LI Wei-ming XU Ya-wei HU Da-yi Department of Cardiology Tenth People's Hospital 'l'ongJ1University Shanghai 200072 China Medical College Tongji University Shanghai 200072 China

Background The transradial approach is regarded as a useful vascular site for coronary procedures. The aim of this study was to test whether 4Fr catheters assisted by ACIST variable rate injector system can produce comparable angiographic quality and reduce the risk of radial artery injury compared to hand manifold 6 Fr catheters. Methods A total of 1816 patients were studied consecutively, among whom 856 patients received coronary angiography by 4 Fr catheters （4Fr group） and 960 patients by 6 Fr catheters （6Fr group）. Angiographic and procedural characteristics were observed and recorded. The luminal inner radial arterial diameter before and after the procedure were collected. Results The baseline clinical characteristics were similar in both groups. There were no significant differences in procedure time, radiation dose and quality scores in both groups （P 〉0.05）, but more contrast media was delivered in the 6Fr group （P 〈0.001）. The mean radial arterial diameter six months after the procedure in the 6Fr group reduced significantly compared to that measured one day prior to the procedure （P 〈0.001）. Conclusions Coronary angiography using the 4Fr catheters with Acist power injection system can achieve an acceptable diagnostic quality while at the same time minimizing radial artery injury and contrast media consumption.

关键词： angiography radial artery catheterization ultrasonography

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Transradial coronary rotational atherectomy using 5-French guiding catheters

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Chinese Medical Journal 2009年第11期122卷 1356-1358页

作者： Marouane Allouch Zhong Yu Zhu John W. Riddell Remi Sabatier Martial Hamon Department of Cardiology CHU de Caen Normandy France

Transradial coronary stenting using 5-French （5F） guiding catheters has been associated with a higher procedural success rate, a lower frequency of vascular access complications and is well tolerated, particularly i... 详细信息

关键词： rotational atherectomy radial artery elderly

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Successful recanalization of chronic total occlusion of the superior mesenteric artery by transradial approach

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第8期11卷 627-630页

作者： Woo Taek KIM Sung Gyun AHN Jun-Won LEE Joong Kyung SUNG Seung Hwan LEE Junghan YOON Division of Cardiology Wonju College of MedicineYonsei University

It is a challenge to confirm chronic mesenteric ischemia(CMI) as a cause of gastrointestinal(GI) symptoms such as postprandial epigastric bloating,anorexia,and debilitating weight *** intervention for CMI has been gaining popularity because of the high morbidity associated with surgical ***,in EVI for superior mesenteric artery(SMA) occlusion,the transfemoral approach is limited by difficulty in coaxial alignment of the guiding catheter,which leads to insufficient back-up ***,we report on a 58-year-old male patient with chronic total occlusion of the SMA,which was successfully revascularized by endovascular intervention via the left radial *** endovascular therapy may be another treatment option for the treatment of CMI.

关键词： Transluminal angioplasty radial artery Superior mesenteric artery Chronic mesenteric ischemia

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In vivo adaptive response of the peripheral conduit artery in patients with borderline systolic hypertension

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Chinese Medical Journal 2003年第3期116卷 14-17页

作者：陶军靳亚非王礼春唐安丽廖新学杨震马虹 Department of Cardiology First Affiliated Hospital Sun Yat-Sen University Guangzhou 510080 China

Objective To investigate elastic changes of the radial artery, a medium-sized muscular peripheral conduit artery, in patients with borderline systolic hypertension. Methods Using a non-invasive high-resolution echo-tracking device coupled to a photoplethysmography (Finapres system) allowing simultaneous arterial diameter and finger blood pressure monitoring, we measured radial artery elastic parameters of 20 patients with borderline systolic hypertension and 20 normal subjects according to Langewouters *** The diameter of the radial artery of control subjects and those with borderline systolic hypertension at the isobaric level of 100 mmHg and mean arterial pressure was similar, but the compliance and distensibility at similar conditions in patients with borderline systolic hypertension did not further reduced and even increased. Conclusion In patients with borderline systolic hypertension, the adaptive responses of the radial artery compliance and distensibility to increased pressure were directed to maintain its elasticity, contributing to the homeostasis of the cardiovascular system.

关键词： hypertension compliance elasticity radial artery

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