Department of Vascular Surgery, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
Eur J Vasc Endovasc Surg. 2011 Aug;42(2):230-5. doi: 10.1016/j.ejvs.2011.03.011. Epub 2011 Apr 16.
The study aimed to evaluate vascular access site complications (ASCs) after percutaneous interventions (PIs) in our institution for changes in annual incidence and surgical management after increased usage of a vascular closure device (VCD; in all cases: Angioseal™).
All patients who underwent repair of arterial pseudo-aneurysms or access site stenosis/occlusion leading to leg ischaemia (LI) or new-onset disabling claudication (CI) after PIs between 2001 and 2008 were included. Annual rates of procedures and methods of repair of ASC were evaluated.
After a total of 58 453 PIs, 352 patients (0.6%) were operated on for: pseudo-aneurysms (n = 300; 0.51%); and local stenosis/occlusion leading to LI/CI (n = 52; 0.09%). Numbers increased significantly with more widespread VCD use: group A (2001-2004: 2860 VCDs; 28 284 PIs; 10.1%): n = 132 (0.47%); and group B (2005-2008: 11,660 VCDs; 30,169 PIs; 38.6%): n = 220 (0.73%) (p < 0.001). In contrast to similar rates of pseudo-aneurysms (group A: n = 124; 0.44%; group B: n = 176; 0.58%; not significant), a significant increase of operations for local stenoses/occlusions was seen with widespread VCD use: n = 8 versus n = 44 (p < 0.001).
In the era of VCDs, complications are rare. However, use of these devices is not without complications, and may require complex reconstructions.
本研究旨在评估我院经皮介入（PI）术后血管入路部位并发症（ASC）的变化，包括血管闭合装置（VCD；所有情况下均使用 Angioseal™）使用增加后 ASC 的年度发生率和手术处理方式。
纳入 2001 年至 2008 年期间因 PI 后动脉假性动脉瘤或入路部位狭窄/闭塞导致下肢缺血（LI）或新发失能性跛行（CI）而行修复术的所有患者。评估 ASC 处理方法和手术的年度发生率。
共行 58453 例 PI 后，352 例患者（0.6%）因：假性动脉瘤（n=300；0.51%）；和局部狭窄/闭塞导致 LI/CI（n=52；0.09%）行手术治疗。随着 VCD 更广泛的使用，病例数显著增加：A 组（2001-2004 年：2860 个 VCD；28284 例 PI；10.1%）：n=132（0.47%）；和 B 组（2005-2008 年：11660 个 VCD；30169 例 PI；38.6%）：n=220（0.73%）（p<0.001）。尽管假性动脉瘤发生率相似（A 组：n=124；0.44%；B 组：n=176；0.58%；无显著差异），但 VCD 广泛使用后局部狭窄/闭塞的手术数量显著增加：n=8 与 n=44（p<0.001）。
在 VCD 时代，并发症罕见。然而，这些设备的使用并非没有并发症，可能需要复杂的重建。
