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经股动脉经导管主动脉瓣植入术中缝线式血管闭合装置的比较。

Comparison of suture-based vascular closure devices in transfemoral transcatheter aortic valve implantation.

机构信息

Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.

出版信息

EuroIntervention. 2015 Oct;11(6):690-7. doi: 10.4244/EIJV11I6A137.

Abstract

AIMS

The aim of this study was to compare outcomes with the use of two haemostasis strategies after transfemoral transcatheter aortic valve implantation (TAVI) - one Prostar® vs. two ProGlide® devices (Abbott Vascular Inc., Santa Clara, CA, USA).

METHODS AND RESULTS

This was a retrospective study enrolling consecutive patients undergoing fully percutaneous transfemoral TAVI in our centre (Ferrarotto Hospital, Catania, Italy) from January 2012 to October 2014. All patients were dichotomised according to the vascular closure device (VCD) used for common femoral artery haemostasis (Prostar vs. ProGlide). All outcomes were defined according to VARC-2 criteria. The study population encompassed a total of 278 patients. Of these, 153 (55.1%) underwent TAVI using the Prostar, and 125 (44.9%) using two ProGlide devices. Vascular complications occurred in 48 patients (17.3%), being more frequent in the ProGlide group (11.8% vs. 24.0%, p=0.007). Patients who had TAVI using the ProGlide were also more likely to have a higher rate of percutaneous closure device failure (4.6% vs. 12.8%, p=0.013). Percutaneous peripheral intervention was performed in 13.7% and 28.0% of Prostar and ProGlide cases, respectively (p=0.003).

CONCLUSIONS

Patients undergoing transfemoral TAVI had significantly lower rates of vascular complications and percutaneous closure device failures when the Prostar was used compared with two ProGlide devices.

摘要

目的

本研究旨在比较经股动脉经导管主动脉瓣植入术(TAVI)后两种止血策略的结果-一种 Prostar®与两种 ProGlide®装置(美国雅培血管公司,加利福尼亚州圣克拉拉)。

方法和结果

这是一项回顾性研究,纳入了 2012 年 1 月至 2014 年 10 月在我们中心(意大利卡塔尼亚的 Ferrarotto 医院)接受完全经皮经股 TAVI 的连续患者。所有患者根据股总动脉止血使用的血管闭合装置(VCD)(Prostar 与 ProGlide)分为两组。所有结果均根据 VARC-2 标准定义。研究人群共包括 278 例患者。其中,153 例(55.1%)采用 Prostar 进行 TAVI,125 例(44.9%)采用两种 ProGlide 装置。共有 48 例(17.3%)发生血管并发症,ProGlide 组更常见(11.8%比 24.0%,p=0.007)。使用 ProGlide 的 TAVI 患者也更有可能出现更高的经皮闭合装置失败率(4.6%比 12.8%,p=0.013)。经皮外周介入分别在 Prostar 和 ProGlide 病例中进行了 13.7%和 28.0%(p=0.003)。

结论

与使用两种 ProGlide 装置相比,经股 TAVI 患者使用 Prostar 时血管并发症和经皮闭合装置失败的发生率显著降低。

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