Aramaki Takeshi, Moriguchi Michihisa, Bekku Emima, Endo Masahiro, Asakura Koiku, Boku Narikazu, Yoshimura Kenichi
Division of Interventional Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan,
Cardiovasc Intervent Radiol. 2015 Feb;38(1):40-4. doi: 10.1007/s00270-014-0892-3. Epub 2014 Apr 9.
To assess optimal bed-rest duration after vascular intervention by way of the common femoral artery using 3F introducer sheaths.
Eligibility criteria for this single-center, prospective study included clinically necessary angiography, no coagulopathy or anticoagulant therapy, no hypersensitivity to contrast medium, age >20 years, and written, informed consent. Enrolled patients were assigned to one of three groups (105/group) with the duration of bed rest deceased sequentially. A sheath was inserted by way of the common femoral artery using the Seldinger technique. The first group (level 1) received 3 h of bed rest after the vascular intervention. If no bleeding or hematomas developed, the next group (level 2) received 2.5 h of bed rest. If still no bleeding or hematomas developed, the final group (level 3) received 2 h of bed rest. If any patient had bleeding or hematomas after bed rest, the study was terminated, and the bed rest of the preceding level was considered the optimal duration.
A total of 105 patients were enrolled at level 1 between November 2010 and September 2011. Eight patients were excluded from analysis because cessation of bed rest was delayed. None of the remaining subjects experienced postoperative bleeding; therefore, patient enrollment at level 2 began in September 2011. However, puncture site bleeding occurred in the 52nd patient immediately after cessation of bed rest, necessitating study termination.
To prevent bleeding, at least 3 h of postoperative bed rest is recommended for patients undergoing angiography using 3F sheaths.
通过使用3F穿刺鞘经股总动脉进行血管介入术后，评估最佳卧床休息时间。
本单中心前瞻性研究的纳入标准包括临床必要的血管造影、无凝血功能障碍或抗凝治疗、对造影剂无过敏反应、年龄>20岁以及书面知情同意书。入选患者被分为三组（每组105例），卧床休息时间依次递减。采用Seldinger技术经股总动脉插入穿刺鞘。第一组（1级）在血管介入术后卧床休息3小时。如果没有出血或血肿形成，下一组（2级）卧床休息2.5小时。如果仍然没有出血或血肿形成，最后一组（3级）卧床休息2小时。如果任何患者在卧床休息后出现出血或血肿，研究终止，前一级的卧床休息时间被视为最佳时长。
2010年11月至2011年9月期间，共有105例患者入选1级。8例患者因卧床休息停止延迟而被排除在分析之外。其余受试者均未发生术后出血；因此，2级患者的入组于2011年9月开始。然而，第52例患者在卧床休息停止后立即出现穿刺部位出血，研究不得不终止。
为防止出血，建议使用3F穿刺鞘进行血管造影的患者术后至少卧床休息3小时。
