| By comparing the clinical effects of coronary angiography via brachial artery approach and radial artery approach,to evaluate whether brachial artery approach is safe and reliable,whether it has clinical practical value,and popularize it in clinical practice.MethodA total of 300 patients who were scheduled to undergo coronary angiography in the Department of Cardiology of our hospital from November 2021 to November 2022 were selected.The patients were randomly[1]divided into two groups:radial artery group（n=150）and brachial artery group（n=150）.The success rate of puncture,the success rate of angiography,the time of puncture,the total time of operation and the related complications of puncture site in the two groups were observed and recorded.Color Doppler ultrasonography was used to measure the internal diameter of blood vessels and the peak blood flow velocity at the puncture site before and 72 hours after operation.The vascular puncture injury was evaluated by calculating the change rate of vascular diameter and peak blood flow velocity 72 hours after operation in both groups.The success of puncture,puncture time,total operation time,puncture vascular injury and the occurrence of puncture-related complications were compared between the two groups to evaluate the clinical effect of the two puncture approaches in coronary angiography.Result1.Comparison of general data between two groups of patientsThere was no significant difference in sex,age,BMI,smoking history,hypertension history,diabetes history and hyperlipidemia between the two groups（P>0.05）.2.Comparison of clinical effects between two groups of patients（1）Comparison of observation indicators between the two groups of patients Comparison of one-time puncture success rate,angiographic effect,puncture time and total operation time between the two groupsThe success rate of one puncture in radial artery group was 94.0%（141/150）,which was significantly lower than 99.3%（149/150）in brachial artery group（P<0.05）.Coronary angiography was successfully completed in both radial artery group and brachial artery group（P>0.05）.The success rate of angiographic operation was 100%（P>0.05）.The puncture time of brachial artery group（43.58±4.18s）was longer than that of radial artery group（31.62±3.59s）,but the total operation time of brachial artery group（18.88±3.25min）was significantly shorter than that of radial artery group（23.06±4.19min）（P<0.01）.（2）Comparison of vascular changes in surgical puncture site between the two groupsThe vascular diameter at the puncture site at 72 hours after operation in both groups was smaller than that before operation,but the change rate of vascular diameter in the brachial artery group was lower than that in the radial artery group（（8.80±9.53）%vs（20.93±12.39）%,P<0.01）.The vascular blood flow velocity at the puncture site at 72 hours after operation in both groups was faster than that before operation,but the change rate of vascular blood flow velocity at the puncture site in the brachial artery group was lower than that in the radial artery group（（17.34±18.99）%vs（43.30±26.57）%,P<0.01）.（3）Comparison of the incidence of puncture related complications between the two groupsThe incidence of puncture-related complications was similar between the two groups（P>0.05）.The incidence of puncture-related complications in the radial artery group was 5.3%（8/150）,including 3.3%of vasospasm（5 cases）and 2.0%of radial artery occlusion（3 cases）.The incidence of puncture-related complications in brachial artery group was 1.3%（2/150）,including only hematoma 1.3%（2 cases）.There were no bleeding,vagus nerve reflex,median nerve injury and pseudoaneurysm in both groups.ConclusionCompared with the transradial approach,although the puncture time of the transbrachial artery approach is longer,the total operation time is shortened,the success rate of one puncture is higher,the degree of vascular injury at the puncture site is lower,and the incidence of puncture-related complications tends to decrease. |
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