Department of Cardiology and Intensive Care, Technische Universität Dresden - Heart Center, Dresden, Germany.
EuroIntervention. 2017 Jun 20;13(3):366-370. doi: 10.4244/EIJ-D-16-00865.
Iatrogenic pseudoaneurysms of the femoral artery lead to increased morbidity and mortality, especially when surgical treatment is necessary. Manual compression and thrombin injection are commonly used to occlude the pseudoaneurysms. However, in some cases these treatment options are inapplicable or unsuccessful. The aim of the present study was to examine the feasibility, effectiveness and safety of a novel approach with the use of suture-based closure devices to treat pseudoaneurysms.
Between January 2014 and May 2016, a total of eight iatrogenic pseudoaneurysms of the femoral artery were treated by the interventional closure technique after at least one ineffective attempt at manual compression. After puncture of the cavity, a PTCA guidewire was used to pass the neck of the pseudoaneurysm and a sheath was inserted in the femoral artery. Afterwards, a suture-based closure system (ProGlide) was used to occlude the neck. All eight pseudoaneurysms were successfully obliterated. No complications occurred during the procedure.
The new interventional technique presented in this study fills the gap in successfully treating pseudoaneurysms that cannot be obturated with conventional techniques. By implementing this new technique in clinical practice, a significant number of open surgical repairs could be prevented.
医源性股动脉假性动脉瘤会增加发病率和死亡率，尤其是在需要手术治疗的情况下。手动压迫和凝血酶注射通常用于闭塞假性动脉瘤。然而，在某些情况下，这些治疗选择不适用或不成功。本研究旨在探讨使用缝线闭合装置治疗假性动脉瘤的新方法的可行性、有效性和安全性。
2014 年 1 月至 2016 年 5 月，对 8 例医源性股动脉假性动脉瘤进行了介入性闭合治疗，这些假性动脉瘤在至少一次无效的手动压迫尝试后仍未得到有效治疗。假性动脉瘤的颈部被刺穿后，使用 PTCA 导丝穿过假性动脉瘤的颈部，并将鞘管插入股动脉。随后，使用缝线闭合系统（ProGlide）闭塞颈部。所有 8 例假性动脉瘤均成功闭塞。手术过程中未发生任何并发症。
本研究提出的新介入技术填补了用传统技术无法闭塞假性动脉瘤的空白。通过在临床实践中实施这一新技术，可以预防大量的开放性手术修复。
