Lozano Iñigo, Avanzas Pablo, Moris Cesar
Catheter Cardiovasc Interv. 2007 Oct 1;70(4):538-40. doi: 10.1002/ccd.21137.
Intraaortic balloon counterpulsation (IABP) may be necessary during percutaneous intervention (PCI) and sometimes it would be useful to withdraw it at the end of procedure. We describe the utility of a closure suture device to retrieve the IABP in the cardiac catheterization laboratory immediately after the intervention.
Observational study of nine consecutive high-risk PCI where an 8.5 F IABP had been retrieved at the end of the procedure with a 6 F Perclose with the "preclosure" technique. The baseline clinical characteristics as well as the in-hospital and 90-days follow-up are described.
The patients age was 67.4 +/- 14.9 years (mean 45-85; three patients were >80; 3 females (33.3%). Left main coronary artery was the target lesion in 8 (88.8%) and 4 (44.4%) patients, performed by radial access. Abciximab was used in 7 patients (77.7%). Successful hemostasis was achieved in all the cases without manual or mechanical compression. Only one patient was transferred to the Coronary Care Unit due to advanced age, left main coronary artery stenting, and severe ventricular dysfunction. Five patients (55.5%) were discharged 24 h after the PCI, three (33.3%) 48 h, and only one remained 72 h after the procedure. There were no events in the 90-days follow-up.
The "preclosure" technique with the 6 F Perclose is an ingenious approach to achieve successful hemostasis after IABP removal. It may permit to transfer the patients to units without critical care facilities, shorten the admission and reduce vascular complications in patients with peripheral vascular disease who may need the counterpulsation only during the percutaneous intervention.
在经皮冠状动脉介入治疗（PCI）期间可能需要主动脉内球囊反搏（IABP），有时在手术结束时撤除它会很有用。我们描述了一种闭合缝合装置在介入治疗后立即在心脏导管室中取出IABP的效用。
对9例连续的高危PCI进行观察性研究，这些患者在手术结束时使用6F Perclose通过“预闭合”技术取出了8.5F的IABP。描述了基线临床特征以及住院期间和90天随访情况。
患者年龄为67.4±14.9岁（平均45 - 85岁；3例患者年龄>80岁；3名女性（33.3%）。8例（88.8%）患者的靶病变为左主干冠状动脉，4例（44.4%）经桡动脉途径进行手术。7例（77.7%）患者使用了阿昔单抗。所有病例均成功止血，无需手动或机械压迫。仅1例患者因高龄、左主干冠状动脉支架置入和严重心室功能障碍被转入冠心病监护病房。5例（55.5%）患者在PCI术后24小时出院，3例（33.3%）在48小时出院，仅1例在术后72小时出院。90天随访期间无事件发生。
使用6F Perclose的“预闭合”技术是在撤除IABP后实现成功止血的巧妙方法。它可能允许将患者转移到没有重症监护设施的病房，缩短住院时间，并减少仅在经皮介入治疗期间可能需要反搏的外周血管疾病患者的血管并发症。
