心脏导管插入术后股动脉假性动脉瘤超声引导下压迫治疗失败的相关危险因素。
Risk factors attributed to failure of ultrasound-guided compression for post-cardiac catheterization femoral artery pseudoaneurysms.
作者信息
Shatnawi Nawaf J, Al-Zoubi Nabil A, Jarrah Jadallah, Khader Yousef, Heis Mowafeq, Al-Omari Mamoon H
机构信息
Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan.
Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan.
出版信息
SAGE Open Med. 2019 Apr 16;7:2050312119843705. doi: 10.1177/2050312119843705. eCollection 2019.
BACKGROUND
Femoral pseudoaneurysm is the most important access site complication following cardiac catheterization. Ultrasound-guided compression repair is a safe and effective therapeutic modality with variable failure rates and risk factors. The aim of this study was to investigate which factors were associated with a higher incidence of ultrasound-guided compression repair failure for post-cardiac catheterization femoral pseudoaneurysm.
METHODS
Data were retrospectively collected from medical records at King Abdullah University Hospital during the period from January 2011 to December 2016. A total of 42 patients with post-cardiac catheterization femoral pseudoaneurysm had attempted ultrasound-guided compression repair. Data regarding patients, procedure and aneurysm-related factors were evaluated by univariate analysis and multivariate logistic regression.
RESULTS
Ultrasound-guided compression repair failed in 31% of the patients. Patients with body mass index of ⩾28 kg/m, platelet count of ⩽180,000/L, time lag (age of aneurysm) of >48 h following puncture time, aneurysmal neck diameter of ⩾4 mm and communicating tract length of <8 mm were associated with higher rate of ultrasound-guided compression repair failure in the univariate analysis. In the multivariate analysis, time lag (age of aneurysm) > 48 h (odds ratio = 5.7), body mass index ⩾ 28 kg/m (odds ratio = 7.8), neck diameter > 4 mm (odds ratio = 14.4) and tract length < 8 mm (odds ratio = 18.6) were significantly associated with ultrasound-guided compression repair failure.
CONCLUSION
Ultrasound-guided compression repair for patients with post-cardiac catheterization femoral pseudoaneurysm was successful in 69% of the patients. Risk factors for failed ultrasound-guided compression repair were as follows: delayed ultrasound-guided compression repair of >48 h, body mass index ⩾ 28 kg/m, wide neck diameter > 4 mm and short aneurysmal communication tract < 8 mm.
背景
股动脉假性动脉瘤是心脏导管插入术后最重要的穿刺部位并发症。超声引导下压迫修复是一种安全有效的治疗方式，但其失败率和危险因素各不相同。本研究的目的是调查哪些因素与心脏导管插入术后股动脉假性动脉瘤超声引导下压迫修复失败的较高发生率相关。
方法
回顾性收集2011年1月至2016年12月期间阿卜杜拉国王大学医院的病历资料。共有42例心脏导管插入术后股动脉假性动脉瘤患者尝试进行超声引导下压迫修复。通过单因素分析和多因素逻辑回归对患者、手术及动脉瘤相关因素的数据进行评估。
结果
31%的患者超声引导下压迫修复失败。在单因素分析中，体重指数≥28kg/m²、血小板计数≤180,000/L、穿刺时间后动脉瘤龄>48小时、瘤颈直径≥4mm以及交通道长度<8mm的患者超声引导下压迫修复失败率较高。在多因素分析中，动脉瘤龄>48小时（比值比=5.7）、体重指数≥28kg/m²（比值比=7.8）、瘤颈直径>4mm（比值比=14.4）和交通道长度<8mm（比值比=18.6）与超声引导下压迫修复失败显著相关。
结论
心脏导管插入术后股动脉假性动脉瘤患者超声引导下压迫修复的成功率为69%。超声引导下压迫修复失败的危险因素如下：超声引导下压迫修复延迟>48小时、体重指数≥28kg/m²、宽瘤颈直径>4mm以及短的动脉瘤交通道<8mm。
Zotero 插件