Taha Ammar, Walsh Ellen K, Wright Kathryn A, Ahmed Iftikhar, Supakul Nucharin, Awwad Eric E, Tejada Juan G
Department of Radiology, Interventional Neuroradiology, Indiana University School of Medicine; Indianapolis, IN, USA - E-mail:
Interv Neuroradiol. 2013 Sep;19(3):353-8. doi: 10.1177/159101991301900313. Epub 2013 Sep 26.
This retrospective study evaluated the safety and feasibility of a new arterial femoral access closure device in neurointerventional procedures. The study includes all consecutive adult patients who underwent femoral arteriotomy closure with the MynxGrip™ closure device after Neurointerventional procedures performed between June and December 2012. All patients had a follow-up color Doppler ultrasound (US) within 48 hours after the procedure, which was independently interpreted by two experienced radiologists to evaluate for access site complications. Device success/failure, sheath size, ambulation time, and periprocedural complications were recorded. Fifty-five closure devices were deployed in 53 patients. There were 23 (43%) males and 30 (57%) females; age ranged from 22 to 84 years (mean: 52.1 years). Thirty of the 55 procedures (55%) were therapeutic and 25 were diagnostic interventions (45%). Sheath sizes used were 5F in 35 procedures (64 %) and 6F in 20 procedures (36%). The right femoral artery was accessed in 51 procedures (93 %) and the left in four procedures (7%). There was only one (1.8 %) minor periprocedural complication (small hematoma). Hemostasis was successful in 51 of the 55 procedures (93 %) with subsequent early ambulation. No device-induced complications associated with serious clinical sequelae were reported. In our small series, the MynxGrip™ femoral access closure device provided a safe and feasible way of closing the femoral artery puncture site after neurointerventional procedures with low minor complication rates and no major complications. Further large prospective randomized trials are necessary to evaluate the efficacy of the device.
这项回顾性研究评估了一种新型股动脉穿刺闭合装置在神经介入手术中的安全性和可行性。该研究纳入了2012年6月至12月期间接受神经介入手术后使用MynxGrip™闭合装置进行股动脉切开闭合术的所有连续成年患者。所有患者在术后48小时内接受了彩色多普勒超声(US)随访,由两名经验丰富的放射科医生独立解读,以评估穿刺部位并发症。记录装置的成功/失败情况、鞘管尺寸、下床活动时间和围手术期并发症。53例患者共使用了55个闭合装置。其中男性23例(43%),女性30例(57%);年龄范围为22至84岁(平均52.1岁)。55例手术中有30例(55%)为治疗性手术,25例为诊断性干预(45%)。使用的鞘管尺寸为5F的有35例(64%),6F的有20例(36%)。51例手术(93%)穿刺右侧股动脉,4例(7%)穿刺左侧股动脉。仅发生1例(1.8%)围手术期轻微并发症(小血肿)。55例手术中有51例(93%)止血成功,随后患者可早期下床活动。未报告与严重临床后遗症相关的装置诱发并发症。在我们的小样本系列研究中,MynxGrip™股动脉穿刺闭合装置为神经介入手术后闭合股动脉穿刺部位提供了一种安全可行的方法,轻微并发症发生率低,无重大并发症。需要进一步进行大型前瞻性随机试验来评估该装置的疗效。