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经皮诊断和介入性心血管手术期间回飞镖钢丝血管通路管理系统与单纯手动压迫的比较:回飞镖™钢丝血管通路管理试验II

Comparison of the boomerang wire vascular access management system versus manual compression alone during percutaneous diagnostic and interventional cardiovascular procedures: The boomerang™ wire vascular access management trial II.

作者信息

Goswami Nilesh J, Smalling Ronnie G, Sinha Shantanu, Gammon Roger S, Ramaiah Venkatesh G

机构信息

Interventional Cardiology, St. John's - Prairie Heart, Springfield, Illinois.

Interventional Cardiology, Christi Hospital, Pittsburg, Kansas.

出版信息

Catheter Cardiovasc Interv. 2016 Jan 1;87(1):75-81. doi: 10.1002/ccd.25842. Epub 2015 Feb 18.

Abstract

OBJECTIVES

To evaluate the use of the Boomerang™ Wire as an adjunct to manual compression (MC) in patients requiring diagnostic (Dx) or interventional (Ix) percutaneous procedures.

BACKGROUND

MC remains the standard of care for closure of femoral artery access sites. Adjunctive use of a device to facilitate closure, reduce time to hemostasis (TTH) and ambulation (TTA) without increasing complication rates could reduce costs and hospital resource demands.

METHODS

The Boomerang™ Trial was a prospective, multicenter, randomized, controlled trial comparing use of the Boomerang™ wire, (Cardiva Medical, Sunnyvale, CA) in conjunction with MC versus MC alone to achieve hemostasis in Dx and Ix patients undergoing percutaneous procedures requiring femoral artery access. Endpoints included TTH, TTA, major, and minor access-site related complications. Subjects were randomized 3:1, Boomerang versus MC.

RESULTS

No minor or major device-related adverse events were reported. Nondevice related complication rates were 3 (0.9%) in the Boomerang arm (n = 327) and 1 (0.8%) in MC arm (n = 123). Mean TTH for Boomerang vs. MC was 11.2 ± 4.3 vs. 23.2 ± 11 min for Dx (P < 0.0001) and 13.9 ± 5.4 vs. 38.4 ± 57.3 min for Ix patients (P < 0.0001). Mean TTA for Boomerang vs. MC was 3.3 ± 3.0 vs. 4.5 ± 2.0 hr (P < 0.0001)for Dx and 5.4 ± 3.3 vs. 6.8 ± 3.2 hr (P < 0.0001) for Ix patients.

CONCLUSIONS

Boomerang™ use, in conjunction with MC, was associated with low rates of complications and demonstrated that Boomerang™ as an adjunct to MC can significantly decrease TTH and TTA after both Dx and Ix procedures. © 2015 Wiley Periodicals, Inc.

摘要

目的

评估在需要诊断性(Dx)或介入性(Ix)经皮操作的患者中,使用回飞镖™导丝作为手动压迫(MC)辅助手段的效果。

背景

MC仍然是股动脉穿刺部位闭合的标准治疗方法。辅助使用一种装置来促进闭合、减少止血时间(TTH)和下床活动时间(TTA),同时不增加并发症发生率,可能会降低成本并减少医院资源需求。

方法

回飞镖™试验是一项前瞻性、多中心、随机、对照试验,比较回飞镖™导丝(Cardiva Medical,加利福尼亚州桑尼维尔)联合MC与单独使用MC在接受需要股动脉穿刺的经皮操作的Dx和Ix患者中实现止血的情况。终点包括TTH、TTA、主要和次要穿刺部位相关并发症。受试者按3:1随机分组,回飞镖组与MC组。

结果

未报告与器械相关的轻微或严重不良事件。回飞镖组(n = 327)与MC组(n = 123)的非器械相关并发症发生率分别为3例(0.9%)和1例(0.8%)。Dx患者中,回飞镖组与MC组的平均TTH分别为11.2±4.3分钟和23.2±11分钟(P < 0.0001);Ix患者中,分别为13.9±5.4分钟和38.4±57.3分钟(P < 0.0001)。Dx患者中,回飞镖组与MC组的平均TTA分别为3.3±3.0小时和4.5±2.0小时(P < 0.0001);Ix患者中,分别为5.4±3.3小时和6.8±3.2小时(P < 0.0001)。

结论

回飞镖™导丝联合MC使用,并发症发生率较低,表明回飞镖™导丝作为MC的辅助手段,可显著降低Dx和Ix操作后的TTH和TTA。© 2015威利期刊公司。

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