Risk Factors Of Radial Artery Stenosis And Occlusion After Repeat Transradial Coronary Procedures

Object:The incidence of radial stenosis or occlusion after repeated transradial coronary intervention was investigated by investigating the incidence of radial artery stenosis or occlusion after coronary artery angioplasty.Method:A total of 116 patients who underwent coronary artery intervention with the same radial artery in the Department of Cardiology,People's Hospital of Xinjiang Uygur Autonomous Region from November 2017 to November 2018.The results of preoperative radial artery ultrasonography showed no stenosis or occlusion.In patients with arterial occlusion or ALLEN positive test,the baseline data of the patients were recorded before operation.The usage and dosage of anticoagulant drugs such as heparin,the diameter of the brachial artery sheath,the specific position and frequency of puncture were recorded during the operation,and the hemostasis and hemostasis were performed after operation.At the same time,the patient's radial artery diameter was measured again at the same time.The preoperative and postoperative ultrasound measurements of radial artery diameter,intraoperative and postoperative intervention factors and baseline data were compared.The patients were divided into stenosis or occlusion group and normal group according to whether or not radial artery stenosis or occlusion occurred after operation.The data were analyzed by SPSS20.0 statistical software.For the measurement data,the Student t test or the Mann-Whitney U test was used,and the count data was analyzed by chi-square test.The clinical characteristics of the two groups were compared,and the influencing factors of radial artery stenosis and occlusion after repeated transradial coronary intervention were analyzed by single factor logistic regression analysis and multivariate Logistic forward stepwise regression.The test level: ?=0.05,If P < 0.05,the difference was considered statistically significant.Result:Of the 116 patients,99 were in the normal group,17 in the radial stenosis and occlusion group,14.65% in the radial artery stenosis or occlusion,and 2.10-2.24 in the stenosis or occlusion group.Mm,normal group 2.30(2.10-2.40)mm,of which the positive result was complete occlusion and incomplete occlusion,including 15 cases of complete occlusion and 2 cases of partial occlusion.All patients with postoperative radial artery occlusion or stenosis did not develop hand tissue necrosis due to ischemia and hypoxia.In the univariate analysis,there was no significant difference in hypertension,diabetes history,dyslipidemia,BMI,heparin dosage,secondary operation time,and liver and kidney function.The gender,radial artery diameter,and sheath indwelling time were statistically significant(P < 0.05).In the single factor regression analysis,gender,age,and sheath retention time were statistically different between the two groups,with the sheath retention time P value = 0.022,OR value = 1.007,95% CI = 1.001-1.013,Sex P value = 0.016,OR value = 0.255,95% CI = 0.084-0.775,age P value = 0.045,OR value = 1.054,95% CI = 1.001-1.110.All the study factors were included in the multivariate forward stepwise regression analysis.The time of sheath retention,gender and diabetes history were statistically significant for postoperative radial artery stenosis or occlusion.The sheath retention time P value was 0.0004.,OR value = 1.013,95% CI = 1.004-1.021,gender P value = 0.001,OR value = 0.065,95% CI = 0.013-0.312,history of diabetes P value = 0.010,OR value = 7.986,95% CI = 1.644-38.800.It is indicated that female and sheath retention time are independent risk factors for stenosis or occlusion of the radial artery.The history of diabetes has certain influence on the occurrence of stenosis or occlusion of the radial artery.Conclusion:Long sheath indwelling time,female,previous history of diabetes can increase the risk of postoperative radial artery stenosis or occlusion during brachial artery intervention,reduce sheath indwelling time,actively control blood glucose to avoid arteriosclerosis,reduce transradial involvement The incidence of postoperative radial stenosis and occlusion increases the likelihood that the radial artery will be reused during coronary intervention.