In patients who previously underwent transradial coronary angiography or PCI, operators can safely return to the same radial artery for repeat procedures done within 30 days of the first, a new study shows.
一项新的研究显示，对于既往接受过经桡动脉冠状动脉造影或PCI手术的患者，操作者可以在第一次手术后30天内安全返回同一桡动脉进行重复手术。
Over a 2-year period at a single center, repeat cardiac catheterization via a radial artery was performed in 92% of 626 patients who required the second procedure, with just 2.
在单一中心的2年时间里，626例需要第二次手术的患者中92%通过桡动脉重复心导管检查，只有2例。
7% of patients crossing over to femoral access.
7%的患者交叉进入股通路。
Overall, physicians performed the repeat procedure via the same ipsilateral radial artery in 73% of cases.
总的来说，在73%的病例中，医生通过相同的同侧桡动脉进行了重复手术。
The results, according to the researchers, “suggest that repeat early radial access within 30 days of the index procedure is feasible and safe,” although the success rate is lower the second time than it is in patients undergoing an initial cardiac catheterization using radial access.
根据研究人员的说法，研究结果“表明手术后30天内重复早期放射导管是可行和安全的”，尽管第二次成功率低于使用放射心导管的患者。
“Whatever the timing between two procedures go for it and use the same radial artery,”
“无论两个操作之间的时间安排如何。
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senior researcher Olivier Bertrand, MD (Laval University, Quebec City, Canada), told TCTMD.
高级研究员奥利维尔·伯特兰，医学博士（加拿大魁北克市拉瓦尔大学）告诉TCTMD。
“The limitation is that you should take care to optimize hemostasis and to preserve access in case of possible future procedures.
“限制是，你应该注意优化止血，并在未来可能的手术中保留通路。”
”In a previous study published in 2013, the researchers reported the feasibility of using the same radial artery in multiple procedures, up to 10 times in some patients undergoing successive catheterizations.
在2013年发表的一项研究中，研究人员报告了在多个手术中使用同一桡动脉的可行性，在一些接受连续置管的患者中使用多达10次。
The rate of transradial use for each successive angiography/intervention declined as the patients returned for repeat procedures, noted Bertrand.
伯特朗指出，随着患者返回重复手术，每次连续血管造影/干预的经桡骨使用率下降。
“This was a bit of warning sign to consider the risk of radial artery occlusion and to perhaps emphasize this limitation,” he said.
他说：“这是一个考虑桡动脉闭塞风险的警告信号，也许要强调这一限制。”
Additionally, the time between repeat interventions was longer in their previous study, and for that reason they wanted to study the safety and feasibility of early (≤ 30 days) repeat access.
此外，在他们之前的研究中，重复干预之间的时间更长，因此，他们想研究早期（≤30天）重复访问的安全性和可行性。
As physicians switch to transradial PCI, repeat transradial procedures are increasingly common in clinical practice.
随着医生转向经桡骨PCI，重复经桡骨手术在临床实践中越来越普遍。
For example, a patient might be treated emergently for ACS and then be followed up with a staged PCI in 24 or 48 hours, said Bertrand.
伯特兰说，例如，一名患者可能会接受紧急ACS治疗，然后在24或48小时内进行分期PCI随访。
Additionally, a repeat procedure might be necessary because of suspected complications, such as subacute thrombosis.
此外，由于怀疑有并发症，如亚急性血栓形成，可能需要重复手术。
Mamas Mamas, BMBCh (Keele University, Stoke-on-Trent, England), who was not involved in the study, said the paper is relevant given the absence of clinical data about the feasibility of early repeat radial procedures and their associated outcomes.
BMBCh（基尔大学，英格兰特伦特河畔斯托克）的妈妈们没有参与这项研究，他说，由于缺乏关于早期重复放射放射手术的可行性及其相关结果的临床数据，这篇论文是相关的。
“This is particularly important as the reasons for undertaking such very early procedures include the management of acute complications such as stent thrombosis where much more aggressive pharmacological strategies would be used and the patients would be more hemodynamically unstable, placing them at particularly high risk of access site related bleeding complications,” Mamas told TCTMD via email.
“这是特别重要的原因进行等早期程序包括急性并发症的管理如支架血栓形成，更积极的药物策略和患者血流动力学不稳定，把他们放在特别高的访问网站相关出血并发症，“妈妈通过电子邮件告诉TCTMD。
“This is borne out by the high risk of femoral complications in this study in the femoral cases.
“在这项研究中，股骨并发症的高风险证实了这一点。
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