Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Catheter Cardiovasc Interv. 2010 Mar 1;75(4):488-92. doi: 10.1002/ccd.22295.
To report the feasibility of a collagen-mediated closure device using a modified Angio-Seal closure technique for access site management following percutaneous balloon aortic valvuloplasty (BAV).
With the advent of percutaneous aortic valve replacement therapies, there has been a resurgence of interest in BAV procedures. Vascular complications, including bleeding, are a common source of morbidity post procedure as a result of the requirement for large bore femoral artery access. The use of vascular closure devices may reduce bleeding complications.
We describe a new technique for vascular closure in this setting. At the conclusion of the valvuloplasty procedure, two 0.035'' wires are inserted through the femoral artery sheath. A conventional collagen-mediated closure device (8F Angio-Seal) is deployed over the first wire and along side the second wire. If immediate hemostasis is not achieved, a second device is loaded onto the second wire and deployed to achieve hemostasis.
Percutaneous BAV was performed in 21 patients. Hemostasis was successfully achieved in all patients with either a single 8F Angio-Seal closure device (18 patients) or after placement of a second device (three patients).
The modified "Double Wire" Angio-Seal technique is a feasible method for hemostasis following percutaneous BAV.
报告一种使用改良的 Angio-Seal 闭合技术的胶原介导闭合装置在经皮球囊主动脉瓣成形术（BAV）后用于经皮股动脉入路管理的可行性。
随着经皮主动脉瓣置换治疗的出现，BAV 手术再次受到关注。血管并发症，包括出血，是由于需要大口径股动脉入路而导致术后发病率的常见原因。使用血管闭合装置可能会减少出血并发症。
我们在这种情况下描述了一种新的血管闭合技术。在球囊成形术结束时，将两根 0.035"导丝插入股动脉鞘内。将传统的胶原介导闭合装置（8F Angio-Seal）放置在第一根导丝上，并沿第二根导丝放置。如果不能立即止血，则将第二根导丝加载到第二根导丝上并部署以实现止血。
对 21 例患者进行了经皮 BAV。所有患者均成功止血，要么使用单个 8F Angio-Seal 闭合装置（18 例），要么使用第二个装置（3 例）。
改良的“双导丝”Angio-Seal 技术是经皮 BAV 后止血的一种可行方法。
