CAJ | 학술논문

目的：回顾分析球囊扩张法在缓解顽固性桡动脉痉挛中的疗效和安全性。方法选择18例经桡动脉造影成功，冠状动脉病变严重需要行 PCI 治疗的患者，因桡动脉痉挛 Guiding 不能通过，反复给血管扩张药物无效。经 Guiding 送入 PTCA 导丝通过桡动脉痉挛部位，沿导丝进入2.0×20 mm 预扩张球囊至痉挛部位缓慢加压扩张，在痉挛减轻后退出 PTCA 导丝，换用超滑造影导丝，轻轻推送 Guiding 后顺利通过痉挛部位，进行后续 PCI 治疗。术后行桡动脉造影明确有无损伤，并观察有无前臂血肿，术后2周门诊复查有无桡动脉闭塞。结果经球囊扩张后 Guiding 均能顺利通过桡动脉痉挛部位；术后造影未见桡动脉造影剂外渗；无前臂血肿发生；2周后复查仅有1例患者桡动脉闭塞，但与球囊扩张无关。结论对血管活性药物无效的顽固性桡动脉痉挛，使用小球囊低压力扩张效果显著，并且较为安全。
목적：회고분석구낭확장법재완해완고성뇨동맥경련중적료효화안전성。방법선택18례경뇨동맥조영성공，관상동맥병변엄중수요행 PCI 치료적환자，인뇨동맥경련 Guiding 불능통과，반복급혈관확장약물무효。경 Guiding 송입 PTCA 도사통과뇨동맥경련부위，연도사진입2.0×20 mm 예확장구낭지경련부위완만가압확장，재경련감경후퇴출 PTCA 도사，환용초활조영도사，경경추송 Guiding 후순리통과경련부위，진행후속 PCI 치료。술후행뇨동맥조영명학유무손상，병관찰유무전비혈종，술후2주문진복사유무뇨동맥폐새。결과경구낭확장후 Guiding 균능순리통과뇨동맥경련부위；술후조영미견뇨동맥조영제외삼；무전비혈종발생；2주후복사부유1례환자뇨동맥폐새，단여구낭확장무관。결론대혈관활성약물무효적완고성뇨동맥경련，사용소구낭저압력확장효과현저，병차교위안전。
Objective To analyze the efficacy and safety of balloon dilation in treating radial artery spasm. Methods Eighteen patients who received coronary angiography via radial artery access successfully were chosen. But after angiography the radial artery spasm happened and guiding catheter could not pass the spasm position. The PTCA guide wire was delivered through guiding catheter into radial artery,then a 2. 0 × 20 mm balloon was sent to the spasm position and dilated in 8 atm for 20 seconds. Then balloon and guide wire were moved away,and the guiding catheter could pass through the spasm position successfully. After op-eration the patients were closely observed to find whether their radial artery were injured. Results Guiding catheter could pass through the spasm position successfully in all the 18 patients after balloon dilation. And no radial artery injury was observed. Conclusion Balloon dilation is effective and safe in treating stubborn radial spasm.