Application of different methods of ischemic preconditioning in radial artery in elderly patients undergoing transradial coronary intervention

Objective To observe the effect of different methods of ischemic preconditioning (IPC) in elderly patients undergoing transradial coronary intervention (TRI).

Methods A total of 459 elderly patients with elective TRI were randomly divided into A group, B group and C group, with 153 cases in each group. Among them, 3 patients in the A group could not tolerate IPC and withdrew halfway, and 150 patients were eventually included. In group A, IPC was performed on both upper limbs with an ischemic preconditioning trainer, and the cuff pressure was 200 mmHg; the IPC was performed on both upper limbs of group B and C with ischemic preconditioning trainer and customized intelligent sphygmomanometer, respectively, and the cuff pressure was higher than the bilateral brachial artery systolic pressure (50 mmHg). Cyanosis time of hand, nurse operation time, numbness score, the incidence of subcutaneous hemorrhagic spots on upper arm, angina during operation as well as ST segment deviation >1 mm, heart rate, postoperative hand swelling, pain score and radial artery stenosis before discharge of three groups were compared.

Results During IPC, the cyanosis time of hands in the B group and C group was significantly later than that in the A group, and the numbness score and incidence of subcutaneous hemorrhagic spots on upper arm were significantly lower than those in the A group (P < 0.05); the operation time of nurses in the A group and C group was significantly shorter than that in the B group, and that in the C group was significantly shorter than that in the A group (P < 0.05). During the operation, the incidence of angina pectoris, ST segment deviation >1 mm and heart rate in the A group and C group were significantly lower than those in the B group (P < 0.05). The scores of postoperative hand swelling and pain in the A group and C group were lower than that in the B group, and the rate of radial artery stenosis before discharge was lower than that in the B group (P < 0.05).

Conclusion The application of customized intelligent sphygmomanometer to perform IPC higher than 50 mmHg of brachial artery systolic pressure before surgery has the same effect as the high pressure of 200 mmHg, which reduces the workload, improves the patients' comfort, and reduces the blood capillary injury.