Klinikum Coburg, Med. Klin. II, Coburg, Germany.
EuroIntervention. 2011 Jun;7(2):242-7. doi: 10.4244/EIJV7I2A39.
The vascular closure device (VCD) Angio-Seal is an easy-to-use system for the closure of arterial puncture sites after percutaneous coronary intervention (PCI), and allows for early mobilisation of the patient. However, little data are available about exercising early after the use of VCD's in PCI patients.
A total of 230 consecutive patients were screened. Of these, 45 (20%) were excluded due to the inability to perform exercise testing, or anatomical conditions which prevented the insertion of a VCD. The 185 remaining patients (139 male, mean age 68 ± 12 years) received Angio-Seal after PCI. After four hours, 30 patients (16%) showed a small local haematoma, 11 patients (6%) complained about minor -and one patient (0.5%) about strong- groin pain. There were no major bleeding complications, six pseudo-aneurysmata, and one arterio-venous fistula. Overall, nine patients (6%) showed moderate to severe groin problems. Patients without major complications underwent bicycle cardiopulmonary exercise testing the subsequent day. Exercise testing was performed up to 136 ± 60 W in 176 patients (94%). Maximum workload was 104 ± 33 W, peak oxygen consumption 17.6 ± 5.1 ml/min/kg, and oxygen consumption at the anaerobic threshold 15.4 ± 4.2 ml/min/kg. After exercise testing there were no cardiovascular complications noted.
In patients receiving VCD after PCI, exercise testing above the anaerobic threshold was feasible after Angio-Seal deployment in those patients with no complications after the use of the device.
血管闭合装置（VCD）Angio-Seal 是一种易于使用的系统，可用于经皮冠状动脉介入治疗（PCI）后动脉穿刺部位的闭合，并允许患者早期活动。然而，关于 PCI 患者使用 VCD 后早期锻炼的数据很少。
共筛选了 230 例连续患者。其中，由于无法进行运动测试或解剖条件阻止 VCD 插入，45 例（20%）被排除在外。其余 185 例患者（139 例男性，平均年龄 68 ± 12 岁）在 PCI 后接受了 Angio-Seal。四小时后，30 例（16%）出现小局部血肿，11 例（6%）诉轻微疼痛-和 1 例（0.5%）诉强烈疼痛。无重大出血并发症，6 例假性动脉瘤，1 例动静脉瘘。总体而言，9 例（6%）患者出现中度至重度腹股沟问题。无重大并发症的患者次日进行了自行车心肺运动测试。176 例患者（94%）进行了运动测试，最高可达 136 ± 60 W。最大工作量为 104 ± 33 W，峰值耗氧量为 17.6 ± 5.1 ml/min/kg，无氧阈时耗氧量为 15.4 ± 4.2 ml/min/kg。运动测试后未发现心血管并发症。
在接受 PCI 后使用 VCD 的患者中，在使用该装置后无并发症的患者中，在 Angio-Seal 放置后进行高于无氧阈的运动测试是可行的。
