Treitl Karla M, Ali Alma, Treitl Marcus
Institute for Clinical Radiology, Hospitals of the Ludwig-Maximilian-University of Munich, Nussbaumstr. 20, D-80336, Munich, Germany.
Eur Radiol. 2016 Jul;26(7):2359-68. doi: 10.1007/s00330-015-4023-6. Epub 2015 Oct 2.
Vascular closure devices can accelerate haemostasis after arteriotomy, but induce scarring. The aim of the study was to prospectively analyse the feasibility of a novel biodegradable arterial closure device (CD).
Two hundred fifty-five patients (183 male; age 36-98 years) with an access vessel diameter >3 mm received the biodegradable CD after endovascular therapy. Technical success rate, time-to-haemostasis (TTH) and time-to-ambulation (TTA) were measured. Puncture site complications were categorized as minor (local hematoma, minor bleeding) or major (pseudoaneurysm, embolization, dissection, thrombotic occlusion, hematoma/major bleeding requiring surgery, access site infection).
Technical success was achieved in 98.8 % (252 cases); device failure occurred in three cases (1.2 %). The average TTH and TTA were 11.3 ± 26.9 s and 73.0 ± 126.3 min. The major complication rate was 1.6 %, with three pseudoaneurysms and one retroperitoneal bleeding. The minor complication rate was 2.0 %, with five small hematomas. Neither cardiovascular risk factors nor access vessel characteristics had statistically significant influence on adverse events. Re-puncture was uncomplicated in 32 cases after 155.0 ± 128.8 days.
Handling of the new biodegradable CD is safe. The complication rates are tolerably low and comparable to other CDs. Post-procedural sonography showed no significant palpable subcutaneous changes in the access site.
• VCDs can increase time efficiency and patient comfort after intervention. • In this prospective single-centre-study, biodegradable CD was safe and easily applicable. • Its major and minor complication rates are comparable to other CDs. • Its mean time-to-haemostasis and time-to-ambulation were 11.3 ± 26.9 s and 73.0 ± 126.3 min. • Post-procedural sonography showed no significant palpable subcutaneous changes at the access site.
血管闭合装置可加速动脉切开术后的止血,但会导致瘢痕形成。本研究的目的是前瞻性分析一种新型可生物降解动脉闭合装置(CD)的可行性。
255例(183例男性;年龄36 - 98岁)血管直径>3 mm的患者在血管内治疗后接受了可生物降解CD。测量技术成功率、止血时间(TTH)和下床活动时间(TTA)。穿刺部位并发症分为轻微(局部血肿、轻微出血)或严重(假性动脉瘤、栓塞、夹层、血栓形成性闭塞、需要手术的血肿/大出血、穿刺部位感染)。
技术成功率为98.8%(252例);3例(1.2%)出现装置失败。平均TTH和TTA分别为11.3±26.9秒和73.0±126.3分钟。严重并发症发生率为1.6%,包括3例假性动脉瘤和1例腹膜后出血。轻微并发症发生率为2.0%,包括5例小血肿。心血管危险因素和血管特征对不良事件均无统计学显著影响。155.0±128.8天后,32例再次穿刺未出现并发症。
新型可生物降解CD的操作是安全的。并发症发生率较低,与其他CD相当。术后超声检查显示穿刺部位皮下无明显可触及变化。
•血管闭合装置可提高干预后的时间效率和患者舒适度。•在这项前瞻性单中心研究中,可生物降解CD安全且易于应用。•其严重和轻微并发症发生率与其他CD相当。•其平均止血时间和下床活动时间分别为11.3±26.9秒和73.0±126.3分钟。•术后超声检查显示穿刺部位皮下无明显可触及变化。