Geyik Serdar, Yavuz Kivilcim, Akgoz Ayca, Koc Osman, Peynircioglu Bora, Cil Barbaros, Cekirge Saruhan, Saatci Isil
Radiology Department, Hacettepe University Hospitals, Sihhiye, Ankara, Turkey.
Neuroradiology. 2007 Sep;49(9):739-46. doi: 10.1007/s00234-007-0249-6. Epub 2007 Jun 27.
We evaluated the safety and efficacy of the Angio-Seal closure device used to close arterial puncture sites in patients who had undergone diagnostic cerebral angiography and neurointerventional procedures.
A total of 1,443 Angio-Seal devices were placed in 1,099 patients in the Interventional Neuroradiology Unit between May 2005 and August 2006. Of these, 670 were interventional and 745 were diagnostic cerebral angiographic procedures. In 28 patients bilateral puncture of the femoral arteries was performed for endovascular treatment. In 167 patients 286 repeat diagnostic procedures were performed and 30 interventional procedures were followed by re-closure with an Angio-Seal device at the time of repeat puncture.
The procedural success rate for antegrade closures was 99.7% for all procedures. The device failed in 5 of 745 diagnostic procedures (0.7%). Major complication occurred in one patient only (0.13%) in the diagnostic group. No minor complications were observed in this group. In the interventional group, the major complication rate was 1.4% (10 of 698 closures) and the minor complication rate was 2.4% (17 of 698 closures). However, in the subgroup of patients with cerebral aneurysms who received heparin in combination with antiplatelet agents after the procedure, the major complication rate was 5.3%, but in the carotid/vertebral stenting group it was 0.8%.
Our experience in a relatively large series of patients shows that the use of the Angio-Seal STS vascular closure device is safe and effective in patients undergoing cerebral diagnostic angiography and neurointerventional procedures with an acceptable rate of complications, although the complication rate was higher in the group of patients who received heparin and/or antiplatelet medication.
我们评估了Angio-Seal闭合装置在接受诊断性脑血管造影和神经介入手术的患者中用于闭合动脉穿刺部位的安全性和有效性。
2005年5月至2006年8月期间，介入神经放射科对1099例患者共植入了1443个Angio-Seal装置。其中，670例为介入手术，745例为诊断性脑血管造影手术。28例患者为进行血管内治疗而双侧穿刺股动脉。167例患者进行了286次重复诊断性手术，30例介入手术后在重复穿刺时再次使用Angio-Seal装置进行闭合。
所有手术顺行闭合的成功率为99.7%。745例诊断性手术中有5例（0.7%）装置失败。诊断组仅1例患者（0.13%）发生严重并发症。该组未观察到轻微并发症。介入组严重并发症发生率为1.4%（698次闭合中有10例），轻微并发症发生率为2.4%（698次闭合中有17例）。然而，在术后接受肝素联合抗血小板药物治疗的脑动脉瘤患者亚组中，严重并发症发生率为5.3%，但在颈动脉/椎动脉支架置入组中为0.8%。
我们在相对大量患者中的经验表明，对于接受脑诊断性血管造影和神经介入手术的患者，使用Angio-Seal STS血管闭合装置是安全有效的，并发症发生率可接受，尽管接受肝素和/或抗血小板药物治疗的患者组并发症发生率较高。
