中文摘要：

目的：探讨当挠动脒途径禁忌或失败，经肱动脉路径开展冠状动脉造影及介入治疗的可行性与安全性。方法：回顾分析2014年1月至2017年3月在我院进行冠状动脉造影及介入治疗的88例患者临床资料，其中经肱动脉途径46例，经股动脉途径42例。所有患者均为桡动脉穿刺禁忌或经挠动脉途径失败者。比较两组穿刺耗时、穿刺成功率、穿刺点压迫时间、造影成功率、曝光时间及血管相关并发症。结果：两组患者穿刺成功率及造影成功平均为100％；两组穿刺耗时、曝光时间比较无显著差异（P〉0．05）；穿刺点压迫时间经肱动脉组明显短干经股动脉组，差异具有统计学意义（P〈0．05）；血管相关并发症发生率肱动脉组低于股动脉组，差异无统计学意义（P〉0.05）。结论：经桡动脉途径失败或禁忌情况下，经肱功脉途径行冠状动脉介入诊疗是安全可行的。

英文摘要：

Objective ＂To investigate the safety and feasibility of percutaneous brachial access for coronary angiography and percutaneous coronary intervention when the radial access was not possible. Methods：All the clinical data of 88 patients with coronary artery disease, who underwent coronary angiography and interventional therapy in our hospital from January 2014 to March 2017 were retrospectively evaluated. Among them, 46 cases adopted brachial artery approach, and the other 42 cases resorted to femoral artery approach. All these patients either were with radial artery puncture contraindications or failed the radial artery approach. The puncture time, success rate of puncture, pressing time of puncturing point, coronary angiography success rate, fluoroscopy time and vascular complications were compared between two groups. Results：The success rates of puncture and the coronary angiography of the two groups were both 100%; There was no significant difference between the two groups in the time of puncture and the fluoroscopy time （P 〉 0.05）; The pressing time of puncturing point in brachial group was significantly shorter than that in the femoral artery group（P 〈 0.05）; The incidences of vascular complication was lower than that in the femoral artery group, but the difference was not statistically significant（P 〉 0.05）. ConClusion：Trans-brachial artery coronary angiography approach is safe and feasible in percutaneous coronary diagnosis and treatment, when radial access is not possible.