Clinical Analysis Of Color Doppler Ultrasonography For Brachiocephalic Trunk Tortuosity In Pathway Selection Of Transradial Coronary Angiography

Objective: To investigate the clinical value of Color Doppler ultrasonography(CDU)for Brachiocephalic trunk tortuosity in pathway selection of Coronary angiography(CAG).Methods: 700 patients with unstable angina pectoris undergoing CAG were randomly divided into the test group(n=362)and the control group(n=338).According to the CDU screening with or without brachiocephalic trunk tortuosity,the test group was divided into CDU tortuosity group and CDU non-tortuosity group.Aocording to the CAG sreening with or without brachiocephalic trunk tortuosity,the control group was divided into CAG tortuosity group and CAG non-tortuosity group.Diagnostic accuracy of CDU for brachiocephalic trunk tortuosity,incidence of brachiocephalic trunk tortuosity and its effect on CAG operation success rate,operation time and complications were analyzed.Results:The incidence rates of brachiocephalic trunk tortuosity in test group and control group were 9.4%,10.7% respectively,and the difference between the two groups was not statistically sinificant(P>0.05).The sensitivity of CDU diagnosis for brachiocephalic trunk tortuosity was 94.4%,the specificity was 98.7%.Compared with CDU tortuosity group,CDU non-tortuosity group and CAG non-ortuosity group,the operation success rate was decreased(80.6%versus97.1%?97.9%?99.1% P<0.05)and operation time was increased(18.3±3.9versus13.2±3.2?13.1±2.7?13.1±2.8min,P<0.05)in CAG tortuosity group.The cases of radial spasm were 1,9,1,and 8respectively in CDU tortuosity group,CDU non-tortuosity group,CAG tortuosity group and CAG non-tortuosity group,there was no statistical difference between the groups.1 case of mild aortic dissection and 12 cases of catheter knotting occured in CAG tortuosity group.Conclusion:The sensitivity and specificity of CDU diagnosis for brachiocephalic trunk tortuosity is high.The use of CDU before coronary angiography can guide the interventional doctor to choose a more favorable puncture path,improve the bonanzamodel of surgery,and avert the related operative risk and neopathy of the brachiocephalic trunk tortuosity.