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使用Clo-Sur PAD装置对股动脉穿刺部位进行介入后经皮闭合:初步研究结果。

Postinterventional percutaneous closure of femoral artery access sites using the Clo-Sur PAD device: initial findings.

作者信息

Balzer Jörn Oliver, Schwarz Wolfram, Thalhammer Axel, Eichler Katrin, Schmitz-Rixen Thomas, Vogl Thomas J

机构信息

Department of Diagnostic and Interventional Radiology, University Clinic Frankfurt/Main, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.

出版信息

Eur Radiol. 2007 Mar;17(3):693-700. doi: 10.1007/s00330-006-0279-1. Epub 2006 May 10.

Abstract

The purpose of this study was to evaluate a percutaneous hemostatic device in patients to achieve immediate hemostasis at the vascular access site as well as early ambulation after vascular interventional procedures. In a randomized trial, a hemostatic device (Clo-Sur PAD, Medtronic AVE, Inc., Santa Rosa, CA, USA; n=60) was compared with manual compression (n=60) in patients after endoluminal intervention through an inguinal access (sheath sizes: 5-7 French). Device safety was evaluated by assessing complications within 24 h and 14 days. System efficacy was measured by the percentage of achieved immediate hemostasis and early ambulation. Device application was possible in 57 cases (95.0%), with 93.3% (56/60) of the patients rising 2 h after application. Hemostasis time was 10.15+/-1.96 min (control group: 16.20+/-1.79 min), with a pressure bandage time of 3.47+/-5.53 h (control group: 13.8+/-4.32 h). Ambulation was possible after 2.13+/-0.50 h (control group: 8.57+/-3.47 h). Complications encountered were access-site bleeding with hematoma (device: n=3; control: n=9). All complications were managed conventionally without blood transfusion or surgical intervention. The system is an easy to use device permitting early ambulation without additional pressure bandaging in the majority of patients. Preliminary data show that hemostasis does not depend on the level of anticoagulation.

摘要

本研究的目的是评估一种经皮止血装置,用于患者在血管介入术后实现血管穿刺部位的即时止血以及早期活动。在一项随机试验中,将一种止血装置(美国加利福尼亚州圣罗莎市美敦力AVE公司的Clo-Sur PAD;n = 60)与手动压迫(n = 60)在经腹股沟入路进行腔内介入治疗后的患者(鞘管尺寸:5-7法国规格)中进行比较。通过评估24小时内和14天内的并发症来评估装置安全性。通过即时止血和早期活动实现的百分比来衡量系统疗效。57例(95.0%)患者成功应用了该装置,93.3%(56/60)的患者在应用后2小时即可起身活动。止血时间为10.15±1.96分钟(对照组:16.20±1.79分钟),加压包扎时间为3.47±5.53小时(对照组:13.8±4.32小时)。2.13±0.50小时后即可活动(对照组:8.57±3.47小时)。出现的并发症为穿刺部位出血伴血肿(装置组:n = 3;对照组:n = 9)。所有并发症均采用常规方法处理,无需输血或手术干预。该系统是一种易于使用的装置,可使大多数患者无需额外加压包扎即可早期活动。初步数据表明,止血不依赖于抗凝水平。

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