Hon Lye-Quen, Ganeshan Arul, Thomas Steven Mark, Warakaulle Dinuke, Jagdish Jagalpathy, Uberoi Raman
Radiology Department, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Curr Probl Diagn Radiol. 2009 Jan-Feb;38(1):33-43. doi: 10.1067/j.cpradiol.2008.02.002.
The use of closure devices is widespread and becoming more common. Radiologists performing arterial access procedures should be aware of when and how to use them, as well as the advantages and disadvantages of various devices, and any complications that may occur. This review intends to provide an overview of these devices, focusing on how they work, their efficacy in achieving hemostasis, any risks associated with their use, and our view as to which should be used for particular indications. There are three main categories of vascular closure devices: collagen based, suture based, and staples and clips. Newer generation devices use the same technique of closure and there are some that utilize newer techniques. Vascular closure devices have been demonstrated to reduce time to hemostasis, facilitate ambulation, and potentially decrease length of stay. The choice of a device would depend on the availability of that particular device, operator preference, anticipation of repeat arterial access, and size of the arteriotomy hole.
封堵装置的使用非常广泛且越来越普遍。进行动脉穿刺操作的放射科医生应该了解何时以及如何使用这些装置,以及各种装置的优缺点,以及可能出现的任何并发症。本综述旨在对这些装置进行概述,重点关注它们的工作原理、实现止血的效果、使用相关的任何风险,以及我们对于特定适应症应使用哪种装置的看法。血管封堵装置主要有三大类:基于胶原蛋白的、基于缝线的以及吻合钉和夹子。新一代装置采用相同的封堵技术,也有一些采用更新的技术。血管封堵装置已被证明可缩短止血时间、便于活动,并有可能缩短住院时间。装置的选择将取决于该特定装置的可用性、操作者的偏好、再次动脉穿刺的预期,以及动脉切开孔的大小。