Objective:To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Metho...Objective:To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Methods:On the basis of arterial access,113 patients who underwent CAG or PCI in Kunshan Hospital of Traditional Chinese Medicine between January and October 2018 were divided into two groups:a right distal radial artery group(52 patients)and a right radial artery group(61 patients).We collected general information,the number of puncture attempts,access times,postoperative compression time,and complications.Results:The general characteristics,rate of successful radial artery puncture,and rate of successful catheter placement in the two groups were not different.The right radial artery group had fewer puncture attempts(1.26±0.44 times vs.2.19±0.53 times,P=0.001)and a shorter access time(3.23±0.86 min vs.4.77±1.49 min,P=0.001)than the right distal radial artery group.However,the postoperative compression time in the right distal radial artery group was shorter(3.44±0.9 h vs.7.16±1.21 h,P=0.001).Two cases of bleeding,four cases of hematoma,and one case of artery occlusion in the right radial artery group and one case of hematoma in the right distal artery group occurred before discharge.The rate of total complications in the right distal radial artery group was lower than in the right radial artery group(1.93%vs.11.48%,P=0.048).Conclusion:CAG or PCI through the right distal radial artery is feasible and safe.展开更多
Objective: To evaluate the efficacy and safety of patient-controlled analgesia(PCA) with hydromorphone as perioperative analgesia during uterine artery embolization(UAE) via the right radial artery.Patients and method...Objective: To evaluate the efficacy and safety of patient-controlled analgesia(PCA) with hydromorphone as perioperative analgesia during uterine artery embolization(UAE) via the right radial artery.Patients and methods: A total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone(10 mg) was dispensed into a 100 ml PCA pump with normal saline. Pump administration was initiated 15 min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 h after the procedure. Side effects were also observed.Results: Thirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were observed.Conclusion: Patients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.展开更多
Dear editor,Radial artery pseudoaneurysm from arterial wall disruption is an extremely rare complication of arterial cannulation.Most prior case reports describe this complication occurring from continuous blood press...Dear editor,Radial artery pseudoaneurysm from arterial wall disruption is an extremely rare complication of arterial cannulation.Most prior case reports describe this complication occurring from continuous blood pressure monitoring or serial blood-gas analysis requiring extended cannulation.The increasing use of radial artery access for coronary angiography and percutaneous coronary intervention(PCI)introduces another susceptible patient population.[1–4]We report a case of a 57-year-old female with right radial artery pseudoaneurysm,diagnosed by bedside ultrasound(US)in the emergency department(ED)five days after transradial cardiac catheterization.展开更多
AIM To compare post-percutaneous coronary intervention(PCI) radial artery occlusion(RAO) incidence between two conventional radial artery compression devices using a novel air-inflation technique.METHODS One hundred c...AIM To compare post-percutaneous coronary intervention(PCI) radial artery occlusion(RAO) incidence between two conventional radial artery compression devices using a novel air-inflation technique.METHODS One hundred consecutive patients post-PCI were randomized 1:1 to Safeguard or TR band compression devices. Post-radial sheath removal, each compression device was inflated with additional 2 m L of air above index bleeding point during air-filled device application and gradually down-titrated accordingly. RAO was defined as absence of Doppler flow signal performed at 24 h and at 6 wk post-PCI. Patients with missing data were excluded. Statistical significance was defined as P < 0.05.RESULTS All patients had 6 F radial sheath inserted. No significant differences were observed between Safeguard Radial(n = 42) vs TR band(n = 42) in terms of age(63 ± 11 years vs 67 ± 11 years), clinical presentation(electives, n = 18 vs n = 16; acute coronary syndrome, n = 24 vs n = 26) and total procedural heparin(7778 ± 2704 IU vs 7825 ± 2450 IU). RAO incidence was not significantly different between groups at 24 h(2% vs 0%, P = 0.32) and 6 wk(0%, both).CONCLUSION Safeguard Radial and TR band did not demonstrate significant between-group differences in short-term RAO incidence. Lack of evidence of RAO in all postPCI patients at 6 wk follow-up, regardless of radial compression device indicate advantage of using the novel and pragmatic air-inflation technique. Further work is required to more accurately confirm these findings.展开更多
Percutaneous coronary intervention for the treatment of coronary artery disease is most commonly performed in the UK through the radial artery,as this is considered to be safer than the femoral approach.However,despit...Percutaneous coronary intervention for the treatment of coronary artery disease is most commonly performed in the UK through the radial artery,as this is considered to be safer than the femoral approach.However,despite improvements in technology and techniques,complications can occur.The most common complication,arterial spasm,can cause intense pain and,in some cases,procedural failure.The incidence of spasm is dependent on several variables,including operator experience,artery size,and equipment used.An antispasmolytic cocktail can be applied to reduce spasm,which usually includes an exogenous nitric oxide(NO)donor(glyceryl trinitrate).NO is an endogenous local vasodilator and therefore is a potential target for anti-spasm intervention.However,systemic administration can result in unwanted side-effects,such as hypotension.A method that adopts local delivery of NO might be advantageous.This review article describes the mechanisms involved in radial artery spasm,discusses the advantages and disadvantages of current strategies to reduce spasm,and highlight the potential of NO-loaded nanoporous materials for use in this setting.展开更多
BACKGROUND:In this study,we attempted to find the relations between blood pressure(BP)measured on the brachial artery(bBP) and BP assessed on the radial artery(rBP) in the right arm.METHODS:Three hundred and fifteen p...BACKGROUND:In this study,we attempted to find the relations between blood pressure(BP)measured on the brachial artery(bBP) and BP assessed on the radial artery(rBP) in the right arm.METHODS:Three hundred and fifteen patients were enrolled in this study.Those who had peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were excluded.After a 15-minute equilibration and stabilization period after inducation of anesthesia,three bBP and rBP records were obtained sequentially using an oscillometric device with an adult cuff and infant cuff,respectively.Order for each BP was randomized.RESULTS:The bBP was significantly lower than the rBP(P<0.05).The difference between the two values varied from 13 to 18 mmHg in systolic BP(SBP),diastolic BP(DBP) and mean blood pressure(MAP) respectively.And the rBP was positively correlated with the bBP(r=0.872,0.754,0.765;P<0.001,<0.001,<0.001;SBP,DBP,MAP,respectively).CONCLUSION:The bBP value can be evaluated by the noninvasive measurements of rBP using an appropriate cuff in clinical practice.展开更多
Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis.Methods: We analyzed a...Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis.Methods: We analyzed an adverse event using cheese model analysis, "fish bone M analysis, root cause analysis, and other methods.Results: There are three root causes leading to an adverse event: operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event.O>ndusions: We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture.展开更多
BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial access.Patent hemostasis can significantly reduce the risk of radial artery occlusion.Previous stu...BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial access.Patent hemostasis can significantly reduce the risk of radial artery occlusion.Previous studies utilized sophisticated methods to evaluate radial artery patency.Simplified and easily applicable methods for successful patent hemostasis are currently lacking.AIM To determine which method(pulse oximeter vs the traditional radial artery palpation)is better to achieve patent hemostasis.METHODS This prospective,single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July 2019.Patients less than 18 years old,with a history of radial artery disease,or no palpable artery pulse were excluded from the study.Patients were randomly assigned to two groups.In the first group,radial artery flow was assessed by palpation of the artery during hemostasis(traditional method).In the second group,radial artery patency was estimated with the use of a pulse oximeter.Two different compression devices were used for hemostasis(air chamber and pressure valve).The primary study endpoint was the achievement of successful patent hemostasis.RESULTS The two groups(pulse oximeter vs artery palpation)had no significant differences in age,sex,body mass index,risk factors,or comorbidities except for supraventricular arrhythmias.The percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group(82.2%vs 68.1%,P=0.005).A lower percentage of patients with spasm was recorded in the pulse oximeter group(9.9%vs 19.0%,P=0.024).The incidence of local complications,edema,bleeding,hematoma,vagotonia,or pain did not differ between the two groups.In the multivariate analysis,the use of a pulse oximeter(OR:2.35,95%CI:1.34-4.13,P=0.003)and advanced age(OR:1.04,95%CI:1.01-1.07,P=0.006),were independently associated with an increased probability of successful patent hemostasis.The type of hemostatic device did not affect patent hemostasis(P=0.450).CONCLUSION Patent hemostasis with the use of pulse oximeter is a simple,efficient,and safe method that is worthy of further investigation.Larger randomized studies are required to consider its clinical implications.展开更多
Objectives: The radial artery is used as a second arterial conduit in coronary artery bypass surgery. However, concerns exist about the thermal injury incurred to the radial artery during endoscopic harvest. We sought...Objectives: The radial artery is used as a second arterial conduit in coronary artery bypass surgery. However, concerns exist about the thermal injury incurred to the radial artery during endoscopic harvest. We sought to assess this effect both histologically and radiologically. Methods: From February 2015 to March 2016, 50 consecutive patients undergoing coronary artery bypass surgery utilizing endoscopically harvested radial artery were prospectively studied. Computerized tomography coronary angiography scan was performed randomly in 8 patients who also had their respective radial artery analyzed histologically at the time of harvest. Standard coronary angiography was also performed in 4 additional patients driven by symptoms recurrence. Results: All patients were available for follow up at 1 year following the surgery. There was no mortality during follow-up. Three patients (6%) developed transient complications in the harvest arm which resolved. All radial arteries were patent on follow-up imaging. Histological examination showed integrity of the arterial wall, intact endothelial lining, patent lumens and no significant pathological abnormalities. Conclusion: The use of endoscopic radial artery harvest was associated with few self-limiting morbidities and excellent patency rates. In addition, there was no evidence of any thermal or traumatic injuries sustained to the radial arteries when examined histologically. The use of endoscopically harvested radial arteries appears safe with excellent results.展开更多
Background: Fracture of distal radius with involvement of the ulnar styloid process is a common clinical problem. It can be treated conservatively, usually involving wrist immobilization in plaster cast or surgically....Background: Fracture of distal radius with involvement of the ulnar styloid process is a common clinical problem. It can be treated conservatively, usually involving wrist immobilization in plaster cast or surgically. A key method of surgical fixation is external fixation by distractor. Distractor can be applied either only on the radial side or on both ulnar and radial sides. Materials and Methods: A prospective randomized and comparative study of 1 year duration was conducted on 32 patients admitted in the Department of Orthopaedics of BSMC & H in the age group of 20 to 75 years old with AO types B and C distal radius fracture along with involvement of the ulnar styloid process. The parameters studied were restoration of radial length, restoration of radial angle, intracarpal step-off and palmar tilt which were statistically evaluated and Fisher’s exact test was performed. The two tailed P-value was calculated and both the groups were statistically compared. Results: In our study, 37.5% patients in Group A and 81.25% in Group B had a radial difference Table 1, Chart 1). 43.75% patients in Group A and 87.5% in Group B had radial angle Table 2, Chart 2). 31.25% in Group A and 75% had intra carpal step off Table 3, Chart 3). 62.5% had an abnormal palmar tilt in Group A while only 6.25% had an abnormal palmar tilt in Group B which is extremely statistically significant. On an average, 2 mm of distraction was required in 75% patients of Group A while only 30% patients in Group B required distraction (Table 4, Chart 4). Conclusion: In our study, the radial difference, radial angle, intra carpal step off and palmar tilt returned significantly to normal in the patients treated with distractor on radial side only when compared with distractor application on both radial and ulnar sides for distal radius fracture with ulnar styloid process involvement. Also post-operative distraction required under image intensifier was higher in the group treated with distractor on either side than those with distractor only on radial side.展开更多
BACKGROUND Subclavian artery stenosis refers to the stenosis in the lumen caused by the presence of plaque or thrombus in the subclavian artery.It is a common problem in endovascular interventions.In fact,conventional...BACKGROUND Subclavian artery stenosis refers to the stenosis in the lumen caused by the presence of plaque or thrombus in the subclavian artery.It is a common problem in endovascular interventions.In fact,conventional subclavian artery stenting via the femoral artery approach is effective and safe.Nevertheless,because femoral artery puncture is not easy to stop bleeding,it requires longer femoral artery compression or more expensive hemostatic materials,such as staplers.Patients need to be catheterized and bedridden for a longer time,which may lead to many complications,such as pseudoaneurysm.CASE SUMMARY Herein,we reported a new interventional therapy of subclavian artery.From March 1,2020 to August 31,2021,we operated on four patients with subclavian artery stenting via bilateral radial artery access.CONCLUSION After reviewing four cases of successful placement of clavicular artery stents via bilateral radial arteries,we concluded that bilateral radial artery approach is feasible.Clavicular artery stenting is safe,effective,and timesaving.It is an excellent alternative to the traditional femoral artery procedure,with few complications and high comfort degree.展开更多
Since its initial description as a safe and feasible access route for cardiac catheterization, the radial artery has been increasingly used for percutaneous coronary procedures. The transradial approach for percutaneo...Since its initial description as a safe and feasible access route for cardiac catheterization, the radial artery has been increasingly used for percutaneous coronary procedures. The transradial approach for percutaneous coronary procedures has the advantage of reduced adverse vascular events. Nevertheless, there are chances of transradial procedure failure due to variation in radial artery anatomy. We report a case of high radial artery origin in a 63 year-old-male patient who was taken up for elective radial percutaneous transluminal coronary angioplasty for in-stent restenosis of proximal left anterior descending artery. Subsequently, there was difficulty in negotiating guide wire and balloons, so imaging of radial artery was carried out which clearly demonstrated a high bifurcating radial origin. This case emphasizes the need for imaging of radial artery to delineate underlying anomalies and identifying patients with unfavorable anatomy when technical difficulties are encountered. Imaging in such a situation helps in planning an appropriate strategy.展开更多
Background:Pseudoaneurysm with median nerve injury is a serious complication of radial artery puncture.It is very important to summarize the prevention and treatment experience of this complication through case discus...Background:Pseudoaneurysm with median nerve injury is a serious complication of radial artery puncture.It is very important to summarize the prevention and treatment experience of this complication through case discussion.Case report:A 66-year-old woman was admitted to the hospital because of‘‘paroxysmal chest tightness and suffocation for 5 days.”Coronary angiography was performed.During insertion of the arterial sheath,the patient experienced severe pain in the right forearm,which radiated to the palm.The puncture sheath did not return blood after the sheath core was withdrawn.The sheath was removed and local compression was used to stop bleeding.There was no obvious bleeding at the puncture point,and the compression was removed 6 hours after the procedure.Local swelling and increased tension were seen in the right forearm.At the 1-week follow-up she exhibited swelling,high local tension,small blisters,and bluish-purple skin of the right forearm,with an acceptable right radial artery pulsation.She had severe pain in the affected limb,which radiated to the thumb,index fi nger,and middle fi nger.Case discussion:We discuss the causes of and treatment measures for pseudoaneurysm with median nerve injury caused by radial artery puncture.展开更多
Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought t...Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought to investigate the effectiveness and safety of guiding catheter crossing over spasmodic radial or (and) brachial artery segments by the aid of PCI wire and balloon compared with traditional anti-spasmodic approach. Methods: The clinical data of 168 patients with coronary artery disease (CAD) (group A), whose PCI was performed via radial artery access with radial or (and) brachial artery spasm or (and) dissection and guiding catheter passing through spasmodic segments successfully by the aid of PCI guiding wire and balloon were analyzed retrospectively, simultaneously, the other 73 patients (group B) who used conventional approach to cross over the spasmodic radial or (and) brachial artery segments were treated as the control. The success rate, the time consumption and the complication were compared between the two groups. Findings: There was no significant difference in the spasmodic site between the two groups (all p value > 0.05). The success rate in group A was significantly higher than that in group B (168(100%) vs 28 (38.4%), p (4.2%) vs 14 (19.2%), p Conclusions: It is more effective and safer for guiding catheter crossing over spasmodic or (and) dissected radial or (and) brachial artery segments by the aid of PCI guiding wire and balloon than using the routine approach of administration of anti-spasm drugs for trans-radial PCI.展开更多
<strong>Background: </strong><span style="font-family:Verdana;">Radial artery catheterization is a fundamental approach that is used as a procedural access in the different catheterization ...<strong>Background: </strong><span style="font-family:Verdana;">Radial artery catheterization is a fundamental approach that is used as a procedural access in the different catheterization laboratories so our study is a</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">compari</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;">on between distal radial artery approach and convential traditional transradial approach to explore the fesibility and safety of coronary angiography and percutanous coronary. </span><b><span style="font-family:Verdana;">Aim of the Work: </span></b><span style="font-family:Verdana;">The purpose of our study is a comparison between the conventional transradial approach versus distal transradial approach for diagnostic and interventional coronary procedures. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">This </span></span><span style="font-family:Verdana;">is </span><span style="font-family:Verdana;">a</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">prospective study that included 60 patients who presented to the Cardiology departments in Ahmed Maher</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Teaching Hospital from December 2018 until October 2019 to perform planned Transradial Coronary Angiography and/or coronary intervention</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">T</span><span style="font-family:Verdana;">he study </span><span style="font-family:Verdana;">is </span><span style="font-family:;" "=""><span style="font-family:Verdana;">divided into two groups, group (A) included 30 patients who undergone the procedure through the distal radial approach (The Anatomical Snuffbox)</span><b></b><span style="font-family:Verdana;">and group (B) included 30 patients who undergone the procedure through the traditional Transradial approach. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Thrombosis and hospital stay are higher significant in radial group than distal radial group and patient satisfaction is higher significant in distal radial group than traditional Transradial while there is no significant difference between both groups as regard Success and failure rate of cannulation, bleeding, </span></span><span style="font-family:Verdana;">i</span><span style="font-family:;" "=""><span style="font-family:Verdana;">nfection and duration of the procedure. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">coronary procedures by distal radial approach have minor access complication versus the conventional Transradial approach.</span></span>展开更多
BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for CAG.AIM To assess the efficacy and safety of the DRA v...BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for CAG.AIM To assess the efficacy and safety of the DRA vs RA during CAG.METHODS The following databases were searched through December 2020:MEDLINE,the Cochrane Central Register of Controlled Trials,EMBASE,the World Health Organization International Clinical Trials Platform Search Portal,and Clinical-Trials.gov.Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included.The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm(RAS)and radial artery occlusion(RAO).Study selection,data abstraction and quality assessment were independently performed using the Grading of Recommendations,Assessment,Development,and Evaluation approach.RESULTS Three randomized control trials and 13 registered trials were identified.The two approaches showed similar successful cannulation rates[risk ratio(RR)0.90,95%confidence interval(CI):0.72-1.13].The DRA did not decrease RAS(RR 0.43,95%CI:0.08-2.49)and RAO(RR 0.48,95%CI:0.18-1.29).Patients with the DRA had a shorter hemostasis time in comparison to those with the RA(mean difference-6.64,95%CI:-10.37 to-2.90).The evidence of certainty was low.CONCLUSION For CAG,the DRA would be safer than the RA with comparable cannulation rates.Given the limited data,additional research,including studies with standard protocols,is necessary.展开更多
Ayurvedic and other alternative medical practi-tioners throughout the world have been using pulse diagnosis to detect disease and the organ at distress by feeling the palpations at three close yet precise positions of...Ayurvedic and other alternative medical practi-tioners throughout the world have been using pulse diagnosis to detect disease and the organ at distress by feeling the palpations at three close yet precise positions of the radial artery. This paper presents a robust electro-mechanical system, ‘Nadi Yantra’ which uses piezoelectric based pressure sensors to capture the signals from the radial artery. Morphology of the waveforms obtained from our system concurs with standard physiological arterial signals. Reproducibility and stability of the system has been verified. Signal processing techniques were applied to obtain features such as amplitude, power spectral density, bandpower and spectral centroid to reflect variations in signals from the three channels. Further, wavelet based techniques were used to process the pressure signals and percussion peaks were identified. The interval between the percussion peaks was used to calculate Heart Rate Varibility (HRV), a useful tool for assessing the status of the autonomic nervous system of the human body non-invasively. Time domain indices were calculated from direct measurement of peak-peak (PP) intervals and from differences between the PP intervals. Frequency domain indices such as very low frequency (VLF) power, low frequency (LF) power, high frequency (HF) power, LF/HF ratio were also calculated. Thereafter, nonlinear Poincare analysis was carried out. A map of consecutive PP intervals was fitted to an ellipse using least squares method. Results from 7 datasets are depicted in this paper. A novel pressure pulse recording instrument is deve loped for the objective assessment of the ancient sci-ence of pulse diagnosis. The features calculated using multi resolution wavelet analysis show potential in the evaluation of the autonomic nervous system of the human body.展开更多
Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods...Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods: A total of 72 patients with osteoporotic distal radial fractures who were treated in the hospital between September 2015 and January 2017 were collected and divided into control group (n=36) and observation group (n=36) according to the random number table method. Control group received routine external fixation, and observation group received mid-frequency pulse therapy combined with external fixation. The differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups. After 1 month of treatment, serum BGP, TAC and SOD levels of both groups of patients were higher than those before treatment whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those before treatment, and serum BGP, TAC and SOD levels of observation group were higher than those of control group whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those of control group.Conclusion: Mid-frequency pulse therapy combined with external fixation can promote fracture healing and reduce postoperative inflammatory response and oxidative stress response in patients with osteoporotic distal radial fracture.展开更多
Background: The radial artery (RA) is being used as a second arterial conduit in coronary artery bypass grafting (CABG) patients. Vasospasm during the harvesting is the most common problem, yet. Our goal of this resea...Background: The radial artery (RA) is being used as a second arterial conduit in coronary artery bypass grafting (CABG) patients. Vasospasm during the harvesting is the most common problem, yet. Our goal of this research is to evaluate the effects of different vasodilators on RA blood flow. Material and Method: In our 250 CABG patients who were included into the study, patients were divided into five groups which have the same number of the patients. Before the harvesting of the RA, Allen test and modified Allen test were performed. In group 1, sodium nitroprusside (SNP) was administered via central line. In group 2, nitrogliceryne was applied as a vasodilator agent. In group 3, diltiazem as a calcium channel blocker was used. In group 4, dobutamine was used with a dose of 3micro./kg/min. In the remaining patients, as a control group (CG), normal saline solution was used with the same protocol. RA length and radial artery flow, mean arterial blood pressure, central venous pressure, and heart rate were measured before and 10 minutes after drug administration. Results: No significant differences were found between the groups in respect to age, body surface area, cardiopulmonary bypass time, aortic cross clamp time. A multivariate general linear model was created and revealed the drug (specifically SNP and nitroglycerin) as a predictor to increase flow in the radial artery (p = 0.001 and p = 0.002), respectively. SNP has significantly decreased mean arterial pressure when we compared to nitroglycerin (p 0.05). Conclusions: Our study showed that SNP and nitroglycerin are very effective agents to provide the increasing of RA blood flow. However, statistical comparisons exhibited that intravenous SNP was a very effective vasodilating agent for RA than nitroglycerin.展开更多
Background: The aim of this study is to compare radial artery with saphenous vein grafts which are widely used for coronary bypass, from views of patients’ satisfaction and postoperative findings. Methods: 42 isolate...Background: The aim of this study is to compare radial artery with saphenous vein grafts which are widely used for coronary bypass, from views of patients’ satisfaction and postoperative findings. Methods: 42 isolated coronary bypass (CABG) patients performed during November 2012-April 2013 are included in the study. 30 days after the operation, in patients who had both RA and SV removal made responses to a questionnaire form which included 6 questions about symptoms of extremity. Results: After analyzing the responses and physical examination, there was no difference in terms of quality of life and usefulness of the extremity for daily use between two grafts. 2 patients (2%) have wound infection on the saphenous vein incision and additional surgical procedure was performed and a scar tissue has occurred. There was no statistically significance between uncomfortable symptoms and demographic data. Conclusion: Our study suggested that RA graft using showed a bit more comfortable and suitable effect against SV in our patients. We think that radial arterial grafts should be used more widely in coronary surgery with selected patients.展开更多
文摘Objective:To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Methods:On the basis of arterial access,113 patients who underwent CAG or PCI in Kunshan Hospital of Traditional Chinese Medicine between January and October 2018 were divided into two groups:a right distal radial artery group(52 patients)and a right radial artery group(61 patients).We collected general information,the number of puncture attempts,access times,postoperative compression time,and complications.Results:The general characteristics,rate of successful radial artery puncture,and rate of successful catheter placement in the two groups were not different.The right radial artery group had fewer puncture attempts(1.26±0.44 times vs.2.19±0.53 times,P=0.001)and a shorter access time(3.23±0.86 min vs.4.77±1.49 min,P=0.001)than the right distal radial artery group.However,the postoperative compression time in the right distal radial artery group was shorter(3.44±0.9 h vs.7.16±1.21 h,P=0.001).Two cases of bleeding,four cases of hematoma,and one case of artery occlusion in the right radial artery group and one case of hematoma in the right distal artery group occurred before discharge.The rate of total complications in the right distal radial artery group was lower than in the right radial artery group(1.93%vs.11.48%,P=0.048).Conclusion:CAG or PCI through the right distal radial artery is feasible and safe.
文摘Objective: To evaluate the efficacy and safety of patient-controlled analgesia(PCA) with hydromorphone as perioperative analgesia during uterine artery embolization(UAE) via the right radial artery.Patients and methods: A total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone(10 mg) was dispensed into a 100 ml PCA pump with normal saline. Pump administration was initiated 15 min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 h after the procedure. Side effects were also observed.Results: Thirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were observed.Conclusion: Patients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.
文摘Dear editor,Radial artery pseudoaneurysm from arterial wall disruption is an extremely rare complication of arterial cannulation.Most prior case reports describe this complication occurring from continuous blood pressure monitoring or serial blood-gas analysis requiring extended cannulation.The increasing use of radial artery access for coronary angiography and percutaneous coronary intervention(PCI)introduces another susceptible patient population.[1–4]We report a case of a 57-year-old female with right radial artery pseudoaneurysm,diagnosed by bedside ultrasound(US)in the emergency department(ED)five days after transradial cardiac catheterization.
文摘AIM To compare post-percutaneous coronary intervention(PCI) radial artery occlusion(RAO) incidence between two conventional radial artery compression devices using a novel air-inflation technique.METHODS One hundred consecutive patients post-PCI were randomized 1:1 to Safeguard or TR band compression devices. Post-radial sheath removal, each compression device was inflated with additional 2 m L of air above index bleeding point during air-filled device application and gradually down-titrated accordingly. RAO was defined as absence of Doppler flow signal performed at 24 h and at 6 wk post-PCI. Patients with missing data were excluded. Statistical significance was defined as P < 0.05.RESULTS All patients had 6 F radial sheath inserted. No significant differences were observed between Safeguard Radial(n = 42) vs TR band(n = 42) in terms of age(63 ± 11 years vs 67 ± 11 years), clinical presentation(electives, n = 18 vs n = 16; acute coronary syndrome, n = 24 vs n = 26) and total procedural heparin(7778 ± 2704 IU vs 7825 ± 2450 IU). RAO incidence was not significantly different between groups at 24 h(2% vs 0%, P = 0.32) and 6 wk(0%, both).CONCLUSION Safeguard Radial and TR band did not demonstrate significant between-group differences in short-term RAO incidence. Lack of evidence of RAO in all postPCI patients at 6 wk follow-up, regardless of radial compression device indicate advantage of using the novel and pragmatic air-inflation technique. Further work is required to more accurately confirm these findings.
基金Supported by the European Social Fund and Scottish Funding Council as part of Developing Scotland’s Workforce in the Scotland 2014-2020 European Structural and Investment Fund Programme
文摘Percutaneous coronary intervention for the treatment of coronary artery disease is most commonly performed in the UK through the radial artery,as this is considered to be safer than the femoral approach.However,despite improvements in technology and techniques,complications can occur.The most common complication,arterial spasm,can cause intense pain and,in some cases,procedural failure.The incidence of spasm is dependent on several variables,including operator experience,artery size,and equipment used.An antispasmolytic cocktail can be applied to reduce spasm,which usually includes an exogenous nitric oxide(NO)donor(glyceryl trinitrate).NO is an endogenous local vasodilator and therefore is a potential target for anti-spasm intervention.However,systemic administration can result in unwanted side-effects,such as hypotension.A method that adopts local delivery of NO might be advantageous.This review article describes the mechanisms involved in radial artery spasm,discusses the advantages and disadvantages of current strategies to reduce spasm,and highlight the potential of NO-loaded nanoporous materials for use in this setting.
文摘BACKGROUND:In this study,we attempted to find the relations between blood pressure(BP)measured on the brachial artery(bBP) and BP assessed on the radial artery(rBP) in the right arm.METHODS:Three hundred and fifteen patients were enrolled in this study.Those who had peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were excluded.After a 15-minute equilibration and stabilization period after inducation of anesthesia,three bBP and rBP records were obtained sequentially using an oscillometric device with an adult cuff and infant cuff,respectively.Order for each BP was randomized.RESULTS:The bBP was significantly lower than the rBP(P<0.05).The difference between the two values varied from 13 to 18 mmHg in systolic BP(SBP),diastolic BP(DBP) and mean blood pressure(MAP) respectively.And the rBP was positively correlated with the bBP(r=0.872,0.754,0.765;P<0.001,<0.001,<0.001;SBP,DBP,MAP,respectively).CONCLUSION:The bBP value can be evaluated by the noninvasive measurements of rBP using an appropriate cuff in clinical practice.
文摘Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis.Methods: We analyzed an adverse event using cheese model analysis, "fish bone M analysis, root cause analysis, and other methods.Results: There are three root causes leading to an adverse event: operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event.O>ndusions: We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture.
文摘BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial access.Patent hemostasis can significantly reduce the risk of radial artery occlusion.Previous studies utilized sophisticated methods to evaluate radial artery patency.Simplified and easily applicable methods for successful patent hemostasis are currently lacking.AIM To determine which method(pulse oximeter vs the traditional radial artery palpation)is better to achieve patent hemostasis.METHODS This prospective,single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July 2019.Patients less than 18 years old,with a history of radial artery disease,or no palpable artery pulse were excluded from the study.Patients were randomly assigned to two groups.In the first group,radial artery flow was assessed by palpation of the artery during hemostasis(traditional method).In the second group,radial artery patency was estimated with the use of a pulse oximeter.Two different compression devices were used for hemostasis(air chamber and pressure valve).The primary study endpoint was the achievement of successful patent hemostasis.RESULTS The two groups(pulse oximeter vs artery palpation)had no significant differences in age,sex,body mass index,risk factors,or comorbidities except for supraventricular arrhythmias.The percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group(82.2%vs 68.1%,P=0.005).A lower percentage of patients with spasm was recorded in the pulse oximeter group(9.9%vs 19.0%,P=0.024).The incidence of local complications,edema,bleeding,hematoma,vagotonia,or pain did not differ between the two groups.In the multivariate analysis,the use of a pulse oximeter(OR:2.35,95%CI:1.34-4.13,P=0.003)and advanced age(OR:1.04,95%CI:1.01-1.07,P=0.006),were independently associated with an increased probability of successful patent hemostasis.The type of hemostatic device did not affect patent hemostasis(P=0.450).CONCLUSION Patent hemostasis with the use of pulse oximeter is a simple,efficient,and safe method that is worthy of further investigation.Larger randomized studies are required to consider its clinical implications.
文摘Objectives: The radial artery is used as a second arterial conduit in coronary artery bypass surgery. However, concerns exist about the thermal injury incurred to the radial artery during endoscopic harvest. We sought to assess this effect both histologically and radiologically. Methods: From February 2015 to March 2016, 50 consecutive patients undergoing coronary artery bypass surgery utilizing endoscopically harvested radial artery were prospectively studied. Computerized tomography coronary angiography scan was performed randomly in 8 patients who also had their respective radial artery analyzed histologically at the time of harvest. Standard coronary angiography was also performed in 4 additional patients driven by symptoms recurrence. Results: All patients were available for follow up at 1 year following the surgery. There was no mortality during follow-up. Three patients (6%) developed transient complications in the harvest arm which resolved. All radial arteries were patent on follow-up imaging. Histological examination showed integrity of the arterial wall, intact endothelial lining, patent lumens and no significant pathological abnormalities. Conclusion: The use of endoscopic radial artery harvest was associated with few self-limiting morbidities and excellent patency rates. In addition, there was no evidence of any thermal or traumatic injuries sustained to the radial arteries when examined histologically. The use of endoscopically harvested radial arteries appears safe with excellent results.
文摘Background: Fracture of distal radius with involvement of the ulnar styloid process is a common clinical problem. It can be treated conservatively, usually involving wrist immobilization in plaster cast or surgically. A key method of surgical fixation is external fixation by distractor. Distractor can be applied either only on the radial side or on both ulnar and radial sides. Materials and Methods: A prospective randomized and comparative study of 1 year duration was conducted on 32 patients admitted in the Department of Orthopaedics of BSMC & H in the age group of 20 to 75 years old with AO types B and C distal radius fracture along with involvement of the ulnar styloid process. The parameters studied were restoration of radial length, restoration of radial angle, intracarpal step-off and palmar tilt which were statistically evaluated and Fisher’s exact test was performed. The two tailed P-value was calculated and both the groups were statistically compared. Results: In our study, 37.5% patients in Group A and 81.25% in Group B had a radial difference Table 1, Chart 1). 43.75% patients in Group A and 87.5% in Group B had radial angle Table 2, Chart 2). 31.25% in Group A and 75% had intra carpal step off Table 3, Chart 3). 62.5% had an abnormal palmar tilt in Group A while only 6.25% had an abnormal palmar tilt in Group B which is extremely statistically significant. On an average, 2 mm of distraction was required in 75% patients of Group A while only 30% patients in Group B required distraction (Table 4, Chart 4). Conclusion: In our study, the radial difference, radial angle, intra carpal step off and palmar tilt returned significantly to normal in the patients treated with distractor on radial side only when compared with distractor application on both radial and ulnar sides for distal radius fracture with ulnar styloid process involvement. Also post-operative distraction required under image intensifier was higher in the group treated with distractor on either side than those with distractor only on radial side.
文摘BACKGROUND Subclavian artery stenosis refers to the stenosis in the lumen caused by the presence of plaque or thrombus in the subclavian artery.It is a common problem in endovascular interventions.In fact,conventional subclavian artery stenting via the femoral artery approach is effective and safe.Nevertheless,because femoral artery puncture is not easy to stop bleeding,it requires longer femoral artery compression or more expensive hemostatic materials,such as staplers.Patients need to be catheterized and bedridden for a longer time,which may lead to many complications,such as pseudoaneurysm.CASE SUMMARY Herein,we reported a new interventional therapy of subclavian artery.From March 1,2020 to August 31,2021,we operated on four patients with subclavian artery stenting via bilateral radial artery access.CONCLUSION After reviewing four cases of successful placement of clavicular artery stents via bilateral radial arteries,we concluded that bilateral radial artery approach is feasible.Clavicular artery stenting is safe,effective,and timesaving.It is an excellent alternative to the traditional femoral artery procedure,with few complications and high comfort degree.
文摘Since its initial description as a safe and feasible access route for cardiac catheterization, the radial artery has been increasingly used for percutaneous coronary procedures. The transradial approach for percutaneous coronary procedures has the advantage of reduced adverse vascular events. Nevertheless, there are chances of transradial procedure failure due to variation in radial artery anatomy. We report a case of high radial artery origin in a 63 year-old-male patient who was taken up for elective radial percutaneous transluminal coronary angioplasty for in-stent restenosis of proximal left anterior descending artery. Subsequently, there was difficulty in negotiating guide wire and balloons, so imaging of radial artery was carried out which clearly demonstrated a high bifurcating radial origin. This case emphasizes the need for imaging of radial artery to delineate underlying anomalies and identifying patients with unfavorable anatomy when technical difficulties are encountered. Imaging in such a situation helps in planning an appropriate strategy.
基金the Hebei Province Key Research and Development Program(no.182777166).
文摘Background:Pseudoaneurysm with median nerve injury is a serious complication of radial artery puncture.It is very important to summarize the prevention and treatment experience of this complication through case discussion.Case report:A 66-year-old woman was admitted to the hospital because of‘‘paroxysmal chest tightness and suffocation for 5 days.”Coronary angiography was performed.During insertion of the arterial sheath,the patient experienced severe pain in the right forearm,which radiated to the palm.The puncture sheath did not return blood after the sheath core was withdrawn.The sheath was removed and local compression was used to stop bleeding.There was no obvious bleeding at the puncture point,and the compression was removed 6 hours after the procedure.Local swelling and increased tension were seen in the right forearm.At the 1-week follow-up she exhibited swelling,high local tension,small blisters,and bluish-purple skin of the right forearm,with an acceptable right radial artery pulsation.She had severe pain in the affected limb,which radiated to the thumb,index fi nger,and middle fi nger.Case discussion:We discuss the causes of and treatment measures for pseudoaneurysm with median nerve injury caused by radial artery puncture.
文摘Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought to investigate the effectiveness and safety of guiding catheter crossing over spasmodic radial or (and) brachial artery segments by the aid of PCI wire and balloon compared with traditional anti-spasmodic approach. Methods: The clinical data of 168 patients with coronary artery disease (CAD) (group A), whose PCI was performed via radial artery access with radial or (and) brachial artery spasm or (and) dissection and guiding catheter passing through spasmodic segments successfully by the aid of PCI guiding wire and balloon were analyzed retrospectively, simultaneously, the other 73 patients (group B) who used conventional approach to cross over the spasmodic radial or (and) brachial artery segments were treated as the control. The success rate, the time consumption and the complication were compared between the two groups. Findings: There was no significant difference in the spasmodic site between the two groups (all p value > 0.05). The success rate in group A was significantly higher than that in group B (168(100%) vs 28 (38.4%), p (4.2%) vs 14 (19.2%), p Conclusions: It is more effective and safer for guiding catheter crossing over spasmodic or (and) dissected radial or (and) brachial artery segments by the aid of PCI guiding wire and balloon than using the routine approach of administration of anti-spasm drugs for trans-radial PCI.
文摘<strong>Background: </strong><span style="font-family:Verdana;">Radial artery catheterization is a fundamental approach that is used as a procedural access in the different catheterization laboratories so our study is a</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">compari</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;">on between distal radial artery approach and convential traditional transradial approach to explore the fesibility and safety of coronary angiography and percutanous coronary. </span><b><span style="font-family:Verdana;">Aim of the Work: </span></b><span style="font-family:Verdana;">The purpose of our study is a comparison between the conventional transradial approach versus distal transradial approach for diagnostic and interventional coronary procedures. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">This </span></span><span style="font-family:Verdana;">is </span><span style="font-family:Verdana;">a</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">prospective study that included 60 patients who presented to the Cardiology departments in Ahmed Maher</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Teaching Hospital from December 2018 until October 2019 to perform planned Transradial Coronary Angiography and/or coronary intervention</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">T</span><span style="font-family:Verdana;">he study </span><span style="font-family:Verdana;">is </span><span style="font-family:;" "=""><span style="font-family:Verdana;">divided into two groups, group (A) included 30 patients who undergone the procedure through the distal radial approach (The Anatomical Snuffbox)</span><b></b><span style="font-family:Verdana;">and group (B) included 30 patients who undergone the procedure through the traditional Transradial approach. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Thrombosis and hospital stay are higher significant in radial group than distal radial group and patient satisfaction is higher significant in distal radial group than traditional Transradial while there is no significant difference between both groups as regard Success and failure rate of cannulation, bleeding, </span></span><span style="font-family:Verdana;">i</span><span style="font-family:;" "=""><span style="font-family:Verdana;">nfection and duration of the procedure. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">coronary procedures by distal radial approach have minor access complication versus the conventional Transradial approach.</span></span>
文摘BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for CAG.AIM To assess the efficacy and safety of the DRA vs RA during CAG.METHODS The following databases were searched through December 2020:MEDLINE,the Cochrane Central Register of Controlled Trials,EMBASE,the World Health Organization International Clinical Trials Platform Search Portal,and Clinical-Trials.gov.Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included.The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm(RAS)and radial artery occlusion(RAO).Study selection,data abstraction and quality assessment were independently performed using the Grading of Recommendations,Assessment,Development,and Evaluation approach.RESULTS Three randomized control trials and 13 registered trials were identified.The two approaches showed similar successful cannulation rates[risk ratio(RR)0.90,95%confidence interval(CI):0.72-1.13].The DRA did not decrease RAS(RR 0.43,95%CI:0.08-2.49)and RAO(RR 0.48,95%CI:0.18-1.29).Patients with the DRA had a shorter hemostasis time in comparison to those with the RA(mean difference-6.64,95%CI:-10.37 to-2.90).The evidence of certainty was low.CONCLUSION For CAG,the DRA would be safer than the RA with comparable cannulation rates.Given the limited data,additional research,including studies with standard protocols,is necessary.
文摘Ayurvedic and other alternative medical practi-tioners throughout the world have been using pulse diagnosis to detect disease and the organ at distress by feeling the palpations at three close yet precise positions of the radial artery. This paper presents a robust electro-mechanical system, ‘Nadi Yantra’ which uses piezoelectric based pressure sensors to capture the signals from the radial artery. Morphology of the waveforms obtained from our system concurs with standard physiological arterial signals. Reproducibility and stability of the system has been verified. Signal processing techniques were applied to obtain features such as amplitude, power spectral density, bandpower and spectral centroid to reflect variations in signals from the three channels. Further, wavelet based techniques were used to process the pressure signals and percussion peaks were identified. The interval between the percussion peaks was used to calculate Heart Rate Varibility (HRV), a useful tool for assessing the status of the autonomic nervous system of the human body non-invasively. Time domain indices were calculated from direct measurement of peak-peak (PP) intervals and from differences between the PP intervals. Frequency domain indices such as very low frequency (VLF) power, low frequency (LF) power, high frequency (HF) power, LF/HF ratio were also calculated. Thereafter, nonlinear Poincare analysis was carried out. A map of consecutive PP intervals was fitted to an ellipse using least squares method. Results from 7 datasets are depicted in this paper. A novel pressure pulse recording instrument is deve loped for the objective assessment of the ancient sci-ence of pulse diagnosis. The features calculated using multi resolution wavelet analysis show potential in the evaluation of the autonomic nervous system of the human body.
文摘Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods: A total of 72 patients with osteoporotic distal radial fractures who were treated in the hospital between September 2015 and January 2017 were collected and divided into control group (n=36) and observation group (n=36) according to the random number table method. Control group received routine external fixation, and observation group received mid-frequency pulse therapy combined with external fixation. The differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups. After 1 month of treatment, serum BGP, TAC and SOD levels of both groups of patients were higher than those before treatment whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those before treatment, and serum BGP, TAC and SOD levels of observation group were higher than those of control group whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those of control group.Conclusion: Mid-frequency pulse therapy combined with external fixation can promote fracture healing and reduce postoperative inflammatory response and oxidative stress response in patients with osteoporotic distal radial fracture.
文摘Background: The radial artery (RA) is being used as a second arterial conduit in coronary artery bypass grafting (CABG) patients. Vasospasm during the harvesting is the most common problem, yet. Our goal of this research is to evaluate the effects of different vasodilators on RA blood flow. Material and Method: In our 250 CABG patients who were included into the study, patients were divided into five groups which have the same number of the patients. Before the harvesting of the RA, Allen test and modified Allen test were performed. In group 1, sodium nitroprusside (SNP) was administered via central line. In group 2, nitrogliceryne was applied as a vasodilator agent. In group 3, diltiazem as a calcium channel blocker was used. In group 4, dobutamine was used with a dose of 3micro./kg/min. In the remaining patients, as a control group (CG), normal saline solution was used with the same protocol. RA length and radial artery flow, mean arterial blood pressure, central venous pressure, and heart rate were measured before and 10 minutes after drug administration. Results: No significant differences were found between the groups in respect to age, body surface area, cardiopulmonary bypass time, aortic cross clamp time. A multivariate general linear model was created and revealed the drug (specifically SNP and nitroglycerin) as a predictor to increase flow in the radial artery (p = 0.001 and p = 0.002), respectively. SNP has significantly decreased mean arterial pressure when we compared to nitroglycerin (p 0.05). Conclusions: Our study showed that SNP and nitroglycerin are very effective agents to provide the increasing of RA blood flow. However, statistical comparisons exhibited that intravenous SNP was a very effective vasodilating agent for RA than nitroglycerin.
文摘Background: The aim of this study is to compare radial artery with saphenous vein grafts which are widely used for coronary bypass, from views of patients’ satisfaction and postoperative findings. Methods: 42 isolated coronary bypass (CABG) patients performed during November 2012-April 2013 are included in the study. 30 days after the operation, in patients who had both RA and SV removal made responses to a questionnaire form which included 6 questions about symptoms of extremity. Results: After analyzing the responses and physical examination, there was no difference in terms of quality of life and usefulness of the extremity for daily use between two grafts. 2 patients (2%) have wound infection on the saphenous vein incision and additional surgical procedure was performed and a scar tissue has occurred. There was no statistically significance between uncomfortable symptoms and demographic data. Conclusion: Our study suggested that RA graft using showed a bit more comfortable and suitable effect against SV in our patients. We think that radial arterial grafts should be used more widely in coronary surgery with selected patients.
