Owens John T, Bhatty Shaun, Donovan Robert J, Tordini Andrea, Danyi Peter, Patel Kalpesh, Wegelin Jacob A, Jovin Ion S
Department of Medicine, McGuire VA Medical Center, Virginia Commonwealth University, Richmond, Virginia.
Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia.
Int J Angiol. 2017 Dec;26(4):228-233. doi: 10.1055/s-0037-1607037. Epub 2017 Oct 4.
Vascular access site complications can follow diagnostic coronary and peripheral angiography. We compared the complication rates of the Catalyst vascular closure device, with the complication rates after manual compression in patients undergoing diagnostic angiographic procedures via femoral access. We studied 1,470 predominantly male patients undergoing diagnostic coronary and peripheral angiography. Catalyst closure devices were used in 436 (29.7%) patients and manual compression was used in 1,034 (70.3%) patients. The former were allowed to ambulate after 2 hours, while the latter were allowed to ambulate after 6 hours. Major complications occurred in 4 (0.9%) patients who had a Catalyst device and in 14 (1.4%) patients who had manual compression (odds ratio [OR]: 0.67, 95% confidence interval [CI]: 0.22-2.1, = 0.49). Any complications occurred in 51 (11.7%) patients who had a Catalyst closure device and in 64 (6.2%) patients who had manual compression (OR: 2, CI: 1.4-3, < 0.01). After adjustment for other variables and for a propensity score reflecting the probability to receive the closure device, the association of major complications with the use of the closure device remained not significant (OR: 0.54, 95% CI: 0.17-1.7, = 0.29), while the association of any complications with the use of the Catalyst device remained significant (OR: 1.9, 95% CI: 1.3-2.9, < 0.01). The Catalyst device was not associated with an increased risk of major groin complications but was associated with an increased risk of any complications compared with manual compression. Patients receiving the closure device ambulated sooner.
血管穿刺部位并发症可能发生在诊断性冠状动脉造影和外周血管造影之后。我们比较了在经股动脉途径进行诊断性血管造影的患者中,Catalyst血管闭合装置的并发症发生率与手动压迫后的并发症发生率。我们研究了1470例主要为男性的患者,他们接受了诊断性冠状动脉造影和外周血管造影。436例(29.7%)患者使用了Catalyst闭合装置,1034例(70.3%)患者采用了手动压迫。前者在2小时后允许活动,而后者在6小时后允许活动。使用Catalyst装置的患者中有4例(0.9%)发生了严重并发症,采用手动压迫的患者中有14例(1.4%)发生了严重并发症(优势比[OR]:0.67,95%置信区间[CI]:0.22 - 2.1,P = 0.49)。使用Catalyst闭合装置的患者中有51例(11.7%)发生了任何并发症,采用手动压迫的患者中有64例(6.2%)发生了任何并发症(OR:2,CI:1.4 - 3,P < 0.01)。在对其他变量以及反映接受闭合装置概率的倾向评分进行调整后,严重并发症与使用闭合装置之间的关联仍然不显著(OR:0.54,95% CI:0.17 - 1.7,P = 0.29),而任何并发症与使用Catalyst装置之间的关联仍然显著(OR:1.9,95% CI:1.3 - 2.9,P < 0.01)。与手动压迫相比,Catalyst装置与严重腹股沟并发症风险增加无关,但与任何并发症风险增加有关。接受闭合装置的患者活动更早。