경요골동맥 관상동맥 조영술을 시행하는 환자에서 요골동맥 사행성의 빈도 및 예측인자 = Prevalence and predictors of tortuous radial artery in patients undergoing transradialcoronary angiography

다국어 초록 (Multilingual Abstract)

Background: It is well known that the presence of a tortuous radial artery, in patients undergoing transradial coronary angiography (CAG), may cause undesirable results such as access failure and arterial dissection. Thus, our aim was to investigate the prevalence and predictors of the presence of a tortuous radial artery in patients undergoing transradial CAG. Methods: We prospectively investigated the tortuosity of the radial artery in 158 consecutive patients. The tortuosity of the radial artery was determined by radial angiography. A tortuous radial artery was defined as one with a maximal angulation of more than 45 degrees. To determine the predictors of a tortuous artery, we examined clinical and intra- procedural characteristics. Results: A right radial angiography was easily performed in 154 patients (97.5%) without any complications. A tortuous radial artery was identified in 34 patients (22%). On the univariate analysis, advanced age, female gender, short stature, underweight, hypertension, and absence of progression of the mini-guide wire were significantly associated with the presence of a tortuous radial artery. Significant independent predictors of a tortuous radial artery by multivariate analysis were: advanced age, absence of progression of the mini-guide wire and hypertension. Conclusions: These data showed that the presence of a tortuous radial artery could be predicted by advanced age, absence of progression of the mini-guide wire and a history of hypertension. Thus, identification of a tortuous radial artery prior to coronary angiography may be helpful for a safe transradial CAG in patients at high risk for a tortuous radial artery.(Korean J Med 71:381-387, 2006)

참고문헌 (Reference)

1 "요골동맥을 이용한 관상동맥 조영술 및 중재술의 유용성과 문제점" 30 : 1083-1091, 2000

2 "요골동맥을 이용한 관동맥 조영술의 유용성" 28 : 1670-1676, 1998

3 "요골 동맥의 분지 변형 및 사행성에 관한 고찰" 30 : 82-89, 2000

4 "관상동맥 조영술과 중재술을 위한 요골 접근법:시술 건수가 많은 심도자실에서의 경험과 안전성" 28 : 1452-1464, 1998

5 "Transradial coronary intervention in Japanese patients" 46 : 37-41, 1999

6 "Transradial artery coronary angioplasty" 129 : 1-7, 1995

7 "The new manual of interventional cardiology" 243-, 1997

8 "Radial versus femoral approach for diagnostic coronary angiography in stable angina pectoris" 79 : 1239-1241, 1997

9 "Prevalence and clinical predictors of severe tortuosity of right subclavian artery in patients undergoing transradial coronary angiography" 92 : 1220-1222, 2003

10 "Percutaneous radial artery approach for coronary angiography" 16 : 3-7, 1989

11 "Effect of transradial access on quality of life and cost of cardiac catheterization:a randomized comparison" 138 : 430-436, 1999

12 "Comparison of transradial and transfemoral approaches for coronary angiography and angioplasty in octogenarians" 94 : 1177-1180, 2004

13 "Arteriographic study of variant arterial anatomay of the upper extremities" 12 : 145-148, 1989

14 "Arterial anatomy of the upper extremity" 23 : 115-121, 1982

15 "Anatomical consideration of the radial artery for transradial coronary procedures: arterial diameter, branching anomaly and vessel tortuosity." 101 : 421-427, 2005

16 "Anatomic variations of the radial artery in patients undergoing transradial coronary intervention" 49 : 357-362, 2000

17 "A randomized comparision of percutanesous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study" 29 : 1269-1275, 1997