Baldino Giuseppe, Persi Federica, Mortola Paolo, Gori Amerigo
Department of Vascular and Endovascular Surgery, Galliera Hospital, Genoa, Italy.
EJVES Short Rep. 2018 Oct 30;41:8-9. doi: 10.1016/j.ejvssr.2018.10.001. eCollection 2018.
Percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) using the Perclose ProGlide suture mediated closure device is currently performed on a global scale. A safe, effective, and cheap technique for achieving haemostasis during PEVAR is described that allows the reversible downsizing of the arteriotomy, without using any other devices.
The procedure consists of pulling the blue thread of the pre-implanted ProGlide, advancing the knot close to the arterial wall by pushing it with the dilator of a small introducer sheath, and maintaining the system under tension by grasping the end of the blue thread with a haemostat until bleeding control is achieved.
Seventeen PEVAR femoral access downsizing procedures have been performed between February and June 2018 and no complications were observed. The technique could be useful in everyday practice and has now become the author's standard practice.
目前,全球范围内都在使用Perclose ProGlide缝线介导闭合装置进行经皮血管腔内腹主动脉瘤修复术(PEVAR)。本文描述了一种在PEVAR过程中实现止血的安全、有效且廉价的技术,该技术可在不使用任何其他装置的情况下,使动脉切开处可逆性缩小。
该操作包括拉动预先植入的ProGlide的蓝线,用小导入鞘的扩张器将线结推向动脉壁,使其靠近动脉壁,并用止血钳夹住蓝线末端,使系统保持张力,直至出血得到控制。
2018年2月至6月间共进行了17例PEVAR股动脉入路缩小手术,未观察到并发症。该技术在日常实践中可能有用,现已成为作者的标准操作。