Section of Interventional Radiology, The George Washington University Hospital, Washington, DC, USA.
J Endovasc Ther. 2012 Aug;19(4):497-500. doi: 10.1583/12-3881.1.
To evaluate the feasibility and safety of using the 8-F Angio-Seal vascular closure device (VCD) to seal large-caliber (>8-F) access sites during percutaneous endovascular interventions.
A retrospective review was undertaken of 42 consecutive patients (34 men; mean age 67.8 years, range 36-94) undergoing percutaneous peripheral interventions with sheaths ranging from 9-F to 12-F and subsequent closure using 8-F Angio-Seal VCDs. Single-wall puncture (n = 48) of the common femoral artery was guided by ultrasound in 46 cases and palpation in 2. Forty procedures required therapeutic heparinization during the interventional procedure; protamine was administered in only 5. Per protocol, manual pressure was held for 15 minutes. Clinical and/or imaging follow-up was available in all cases within 3 months after the procedure.
Immediate technical success was achieved in all cases, with hemostasis obtained within 5 minutes (no oozing or hematoma). The overall complication rate was 4.1% (2/48); one hematoma requiring surgical repair occurred 10 hours after VCD deployment. An asymptomatic pseudoaneurysm was discovered on follow-up imaging and was treated with ultrasound-guided thrombin injection with complete resolution.
The use of the 8-F Angio-Seal VCD to close large-caliber arteriotomies ranging from 9-F to 12-F is feasible and safe, with a low complication rate.
评估在经皮血管内介入治疗中使用 8-F Angio-Seal 血管闭合装置（VCD）闭合大口径（>8-F）入路的可行性和安全性。
回顾性分析了 42 例连续患者（34 例男性；平均年龄 67.8 岁，范围 36-94 岁）的资料，这些患者接受了从 9-F 至 12-F 鞘管的经皮外周介入治疗，随后使用 8-F Angio-Seal VCD 进行闭合。46 例采用超声引导，2 例采用触诊引导对股总动脉进行单壁穿刺。40 例介入手术过程中需要进行治疗性肝素化；仅在 5 例中使用了鱼精蛋白。根据方案，手动按压 15 分钟。所有病例均在术后 3 个月内获得了临床和/或影像学随访。
所有病例均即刻获得技术成功，5 分钟内实现止血（无渗血或血肿）。总体并发症发生率为 4.1%（2/48）；1 例血肿在 VCD 放置后 10 小时需要手术修复。在随访影像学检查中发现 1 例无症状假性动脉瘤，采用超声引导下凝血酶注射治疗，完全缓解。
使用 8-F Angio-Seal VCD 闭合 9-F 至 12-F 的大口径动脉切开术是可行且安全的，并发症发生率低。
