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新型血管闭合装置(Glubran 2 封合)在周围动脉闭塞性疾病患者诊断性和介入性血管造影后的疗效和安全性。

Efficacy and safety of a novel vascular closure device (Glubran 2 seal) after diagnostic and interventional angiography in patients with peripheral arterial occlusive disease.

机构信息

Department of Vascular Surgery, University of Pisa, Via Paradisa 2, 56100, Pisa, Italy.

出版信息

Cardiovasc Intervent Radiol. 2013 Apr;36(2):371-6. doi: 10.1007/s00270-012-0428-7. Epub 2012 Jun 14.

Abstract

PURPOSE

To prospectively evaluate safety and efficacy of a novel vascular closure device (Glubran 2 Seal) after peripheral angiography in patients with peripheral arterial occlusive disease (PAOD).

METHODS

From December 2010 to June 2011, all consecutive patients with PAOD undergoing peripheral angiography were prospectively enrolled onto the study after percutaneous antegrade or retrograde puncture of the common femoral artery. After angiography, the Glubran 2 Seal device was used to achieve hemostasis. The following data were registered: technical success and manual compression duration, patients' discomfort (scale 0-5), operators' technical difficulty (scale 0-5), and vascular complications. The site of hemostasis was evaluated by clinical inspection and color-coded Duplex ultrasound performed 1 day and 1 month after the procedure.

RESULTS

One hundred seventy-eight patients were enrolled (112 male, mean age 70.8 years) with a total of 206 puncture sites, including 104 (50.5 %) antegrade accesses. The device was successful in 198(96.1 %) of 206 procedures, with 8 cases of manual compression lasting longer than 5 min (maximum 20 min). No major vascular complications were observed, resulting in 100 % procedural success. Minor complications occurred in seven procedures (3.4 %), including two cases of pseudoaneurysms, successfully treated by ultrasound-guided glue injection. The mean ± standard deviation score for patients' discomfort was 0.9 ± 0.7, whereas the mean score for operators' difficulty was 1.2 ± 0.9.

CONCLUSION

In patients with PAOD, the Glubran 2 Seal represents a simple, painless, and efficient vascular closure device, able to achieve hemostasis both in antegrade and retrograde accesses.

摘要

目的

前瞻性评估新型血管闭合装置(Glubran 2 Seal)在外周动脉阻塞性疾病(PAOD)患者行外周血管造影后的安全性和有效性。

方法

2010 年 12 月至 2011 年 6 月,连续纳入所有因 PAOD 而行外周血管造影的患者,所有患者均经股动脉顺行或逆行穿刺后行前瞻性研究。血管造影后,使用 Glubran 2 Seal 装置实现止血。记录以下数据:技术成功率和手动按压时间、患者不适程度(0-5 分)、操作者技术难度(0-5 分)和血管并发症。术后 1 天和 1 个月通过临床检查和彩色多普勒超声评估止血部位。

结果

共纳入 178 例患者(112 例男性,平均年龄 70.8 岁),共 206 个穿刺部位,其中顺行入路 104 例(50.5%)。198 例(96.1%)的装置操作成功,8 例手动按压时间超过 5 分钟(最长 20 分钟)。无重大血管并发症,手术成功率为 100%。7 例(3.4%)出现轻微并发症,包括 2 例假性动脉瘤,均经超声引导胶注射成功治疗。患者不适评分的平均值±标准差为 0.9±0.7,操作者难度评分的平均值±标准差为 1.2±0.9。

结论

在 PAOD 患者中,Glubran 2 Seal 是一种简单、无痛且有效的血管闭合装置,既能实现顺行入路,也能实现逆行入路的止血。

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