cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2019.1.10218cardio-435Research ArticleРАЗНОЕMISCELLANEOUSАнализ частоты осложнений при раннем удалении компрессионной повязки после коронарной ангиографии трансрадиальным доступомRate of Complications at Early Removal of Compression Bandage After Transradial Coronary AngiographyОгнерубовД. В.OgnerubovD. V.

Москва

Ognerubov Dmitrii V. - post-graduate student

Roenthenendovascular Diagnostic and Treatment Department 

Moscow

ferux_2008@mail.ruПроваторовС. И.ProvatorovS. I.

Москва

Moscow

ТерещенкоА. С.TereshchenkoA. S.

Москва

Moscow

РомасовИ. В.RomasovI. V.

Москва

Moscow

ПогореловаО. А.PogorelovaO. A.

Москва

Moscow

ТрипотеньМ. И.TripotenM. I.

Москва

Moscow

БалахоноваТ. В.BalakhonovaT. V.

Москва

Moscow

МеркуловЕ. В.MerkulovE. V.

Москва

Moscow

СамкоА. Н.SamkoA. N.

Москва

Moscow

ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава РоссииРоссияNational Medical Research Center for CardiologyRussian Federation2019280120195917983Copyright © Kardiomag, 20192019KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/435Цель исследования

Цель исследования. Сопоставить частоту возникновения осложнений в области доступа при раннем (через 4 ч) и традиционном (через 24 ч) удалении компрессионной повязки после диагностической коронарной ангиографии (КГ), выполненной трансрадиальным доступом, у пациентов, не получающих антикоагулянты.

Материалы и методы

Материалы и методы. В исследование включены 392 пациента (средний возраст 63±8,7 года, 62,8 % мужчины), которым выполнена КГ трансрадиальным доступом. Пациенты были разделены на 2 группы. В 1-й группе (n=221) компрессионную повязку с места пункции удаляли через 4 ч после процедуры с последующим контролем проходимости лучевой артерии (ЛА) по наличию пульсоксиметрической кривой при пережатой локтевой артерии (обратный Barbaeu’s тест с пульсоксиметром). Во 2-й группе (n=171) повязку удаляли через 24 ч. В обеих группах проходимость определяли через 24 ч с помощью обратного Barbaeu’s теста. При выявлении окклюзии пациенту проводили ультразвуковое исследование артерий предплечья.

Результаты

Результаты. В 1-й группе окклюзии ЛА не выявлено, во 2-й группе окклюзии были у 15 (8,8 %) пациентов (р<0,05). В сравниваемых группах частота возникновения гематомы в области пункции статистически значимо не различалась. В 1-й группе у 1 (0,6 %) пациента отмечалось кровотечение после удаления компрессионной повязки, потребовавшее повторное наложение повязки. Во 2-й группе таких случаев не зарегистрировано (p>0,05).

Заключение

Заключение. При раннем снятии компрессионной повязки после выполнения КГ трансрадиальным доступом отмечается более низкая чем с при традиционной методике, частота окклюзии ЛА.

Purpose

Purpose: to compare rates of access site complications at early (after 4 hours) and traditional (after 24 hours) removal of a compression bandage after diagnostic transradial (TR) coronary angiography (CA) in patients not receiving anticoagulants.

Materials and methods

Materials and methods. We included into this study 392 patients (mean age 63±8.7 years, 62.8% men) who underwent transradial coronary angiography. Patients were divided into 2 groups. In group 1 patients (n=221) compression bandage was removed from puncture site in 4 hours after procedure with subsequent control of radial artery patency using presence of pulse metric curve during ulnar artery compression (the reverse Barbeau test with pulse oximeter). In patients of group 2 (n=171) compression band was removed after 24 hours. In both groups control of radial artery patency was carried out after 24 hours using the reverse Barbeau test. Upon detection of radial artery occlusion (RAO) ultrasound imaging of the forearm arteries was performed.

Results

Results. No RAO was detected in group 1 while in group 2 number of detected RAO was 15 (8.8%) (р<0.05). Rates of hematomas at puncture site were not significantly different. Puncture site bleeding after band removal requiring repeated banding occurred in 1 patient of group one (0.6%); no such cases were registered in group 2 (p>0.05).

Conclusion

Conclusion. Compared with traditional method early removal of compression bandage after TR CA was associated with lower rate of RAO.

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The authors declare that there are no conflicts of interest present.