Henk Christine B, Grampp Stephan, Heimberger Karl, Czerny Christian, Schindler Erwin, Mostbeck Gerhard H
Department of Radiology, Ludwig-Boltzmann Institute for Clinical and Experimental Radiology, University of Vienna, Währingergürtel 18-20, A-1090 Vienna, Austria.
Eur J Radiol. 2003 Dec;48(3):237-43. doi: 10.1016/s0720-048x(03)00048-2.
To evaluate the use of the suture mediated vascular closure device concerning practicability and safety in clinical angiography practice.
One hundred and seventeen patients (59 female, 58 male, mean age 40.9+/-13.4) underwent percutaneous closure of common femoral arterial puncture sites following diagnostic neuroangiography using the suture device 'the Closer' (Perclose Inc., Redwood City, CA, USA). Primary success, early problems (within 24 h) and late complications were evaluated. Complications were graded as minor and severe with or without need of surgical intervention and categorized by type. Parameters such as age, gender, sheath size and number of previous arterial punctures were evaluated with respect to complications.
Percutaneous closure was primary successful in 85% (100/117). The overall complication rate was 32% (28% mild n=35, 4% severe n=6, which needed surgical intervention). All but one problem occurred within the first 24 h after the suture. Additional manual compression was necessary in 32 cases (25%). There was no significant difference in age and gender between the groups with and without complications. Sheath size was significantly larger (P<0.01) and numbers of preceeding angiograms were significantly higher (P<0.01) in the complications group compared with uncomplicated cases.
The evaluated percutaneous vascular suture device is useful in clinical practice but limitations concerning patient selection seem to emerge in order to avoid complications.
评估缝合介导血管闭合装置在临床血管造影实践中的实用性和安全性。
117例患者（59例女性，58例男性，平均年龄40.9±13.4岁）在诊断性神经血管造影后使用“闭合器”（美国加利福尼亚州红木城的Perclose公司生产）经皮闭合股总动脉穿刺部位。评估一期成功率、早期问题（24小时内）和晚期并发症。并发症分为轻度和重度，有无手术干预需求，并按类型分类。对年龄、性别、鞘管大小和既往动脉穿刺次数等参数进行并发症方面的评估。
经皮闭合一期成功率为85%（100/117）。总体并发症发生率为32%（轻度28%，n = 35；重度4%，n = 6，需手术干预）。除1例问题外，所有问题均发生在缝合后24小时内。32例（25%）需要额外手动压迫。有并发症组和无并发症组在年龄和性别上无显著差异。与无并发症病例相比，并发症组鞘管尺寸显著更大（P < 0.01），既往血管造影次数显著更多（P < 0.01）。
评估的经皮血管缝合装置在临床实践中有用，但为避免并发症，在患者选择方面似乎存在局限性。
