A simple and effective method to prevent the Radial artery occlusion after intervention 防止桡动脉术后闭塞 简单有效的方法 田 军 Tian Jun,MD,FCIT 田 军 Tian Jun,MD,FCIT

Effect of RAO The patient maybe feel gloomy although without ischemic of hand because The patient maybe feel gloomy although without ischemic of hand because The pulsate of RA disappear so that it is difficult to palpate the pulse for Chinese traditional medicine The pulsate of RA disappear so that it is difficult to palpate the pulse for Chinese traditional medicine

Incidence of RAO The incidence is 4% or 5% in the foreign reports 1.Spaulding C, Lefevre T, Funck F, et al. Left radial approach for coronary angiography: results of a prospective study. Cathet Cardiovasc Diagn, 1996; 39: Nagai S, Abe S, Sato T, et al. Ultrasonic assessment of vascular complication in coronary angiography and angioplasty after transradial approach. Am J Cardial, 1999,83: The incidence is about 10% in China 吕树铮等. 主编. 冠脉介入诊治技巧及器械选 择. 北京 : 人民卫生出版社, 2003:

Foreboding of RAO Pulsating of radial artery became weaker than before puncture and of ulnar artery became stronger The ache at the forearm muscle was reduced while the ulnar artery was blocked.

The causes of RAO The artery endothelium was injured by puncture The injured artery was pressed for homeostasis The diameter of sheath≥the diameter of artery The blood was Incomplete heparinization

How to prevent? Our thinking The bloodstream of the brachial artery divides into two branches: radial artery and ulnar artery

Our thinking The bloodstream of the RA reduced even stopped while the RA was pressed, It maybe kept on after loosening. The bloodstream of ulnar artery compensatory increased

The bloodstream of the RA reduced S=59.9 cm/s D=1.39 cm/s MN=11.5 cm/s

The bloodstream of UA increased S=81.2 cm/s D=13.1 cm/s MN=20.4 cm/s

To block persistingly the ulnar artery, so that the bloodstream of the brachial artery could enter almost whole into the radial artery to distend and wash the artery being faced with imminent occlusion Our thinking

Blocking UA to increase the bloodstream of RA S=117 cm/s D=6.97 cm/s MN=27.2 cm/s

Method The sheath was removed immediately postprocedure and the puncture site was enswathed with pressure ； The pressure was released suitably in 2 hours after the procedure and the enswathement was loosened in 4 hours; About one hour after loosening the enswathement the ulnar artery of all patients whose pulsating of RA became weak was blocked persistingly with finger

Patients selection From June 2001 to March 2006 Out of 2658 patients who underwent a TRCI, one hundred eighty-six (7%) whose pulsating of radial artery became weak. 117 of male ， 69 of female

The results The average time of pressing ulnar artery was 4.1±1.18h ( h). There were only 2 patients (1.1%) whose radial artery was occluded. so the efficacious rate of our method is 98.9% and the incidence of RAO is 0.075% in this group patients.

① Tthe location of pressing for blocking ulnar artery was not correct and ② The time of pressing was not enough long for comeback of the radial artery. The causes of failure for 2 patients were:

Thanks your attention