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回顾性评估 EXOSEAL 血管闭合装置在诊断和介入放射学中单点血管闭合和重复穿刺后闭合的安全性和有效性:单中心经验。

Retrospective evaluation of safety and effectiveness of the EXOSEAL vascular closure device for single vascular closure and closure after repeat puncture in diagnostic and interventional radiology: single-center experience.

机构信息

Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany.

出版信息

J Vasc Interv Radiol. 2013 May;24(5):698-702. doi: 10.1016/j.jvir.2013.02.014.

Abstract

PURPOSE

To retrospectively evaluate the safety and effectiveness of the EXOSEAL vascular closure device (VCD) for first or repeated closure after retrograde percutaneous femoral arterial access.

MATERIALS AND METHODS

A retrospective analysis of 417 patients (271 men; mean age, 64.1 y±12.8; age range, 22-94 y) who had undergone arterial closure with the EXOSEAL VCD was performed. Procedures with retrograde femoral access and closure with the 5-F, 6-F, or 7-F EXOSEAL VCD according to the manufacturer's instructions were included. The clinical indications included the full procedural portfolio of a radiologic department with a focus on transarterial hepatic procedures. After EXOSEAL VCD closure, patients were restricted to bed rest for 4 hours.

RESULTS

From August 2010 to March 2012, a total of 682 EXOSEAL VCDs (5-F, n = 276; 6-F, n = 394; 7-F, n = 12) were used in 659 procedures with a total of 404 repeated closures. The EXOSEAL VCD was used successfully in 676 of 682 procedures (99.1%). Hemostasis was achieved in 651 of 682 procedures (95.5%). No major complications were encountered. There were eight cases (1.17%) of minor complications despite a successful vascular closure procedure, none requiring further therapy. There were no complications in any of the 404 cases of repeated vascular closure.

CONCLUSIONS

The results of this study suggest that the EXOSEAL VCD is safe and effective in single and repeated closure of retrograde percutaneous femoral arterial access in interventional radiology cases.

摘要

目的

回顾性评估 EXOSEAL 血管闭合装置(VCD)用于逆行经皮股动脉入路初次或重复闭合的安全性和有效性。

材料和方法

对 417 例(271 例男性;平均年龄 64.1±12.8 岁;年龄范围 22-94 岁)患者进行了回顾性分析,这些患者均采用 EXOSEAL VCD 进行动脉闭合。纳入的操作均为逆行股动脉入路,并根据制造商的说明采用 5-F、6-F 或 7-F EXOSEAL VCD 进行闭合。临床适应证包括放射科的完整程序组合,重点是经动脉肝脏手术。EXOSEAL VCD 闭合后,患者需卧床休息 4 小时。

结果

2010 年 8 月至 2012 年 3 月,共使用 682 个 EXOSEAL VCD(5-F,n=276;6-F,n=394;7-F,n=12),共进行 659 例操作,其中共有 404 例重复闭合。682 例操作中,有 676 例(99.1%)成功使用了 EXOSEAL VCD。682 例操作中,有 651 例(95.5%)实现了止血。未发生重大并发症。尽管血管闭合程序成功,但仍有 8 例(1.17%)出现轻微并发症,均无需进一步治疗。在 404 例重复血管闭合中均未发生并发症。

结论

本研究结果表明,EXOSEAL VCD 用于介入放射学中逆行经皮股动脉入路的单次和重复闭合是安全有效的。

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