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经股动脉经导管主动脉瓣置换术后使用缝线和胶原蛋白介导的闭合装置的混合血管闭合技术的安全性和有效性。

Safety and efficacy of hybrid vascular closure technique using both a suture- and collagen-mediated closure device after transfemoral transcatheter aortic valve implantation.

机构信息

Department of Cardiology, Section for Interventional Cardiology Ullevål, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.

Department of Cardiology, Division of Medicine, Oslo University Hospital, Oslo, Norway.

出版信息

Catheter Cardiovasc Interv. 2020 May 1;95(6):1171-1175. doi: 10.1002/ccd.28419. Epub 2019 Aug 4.

Abstract

OBJECTIVES

To evaluate the clinical utility and feasibility of a hybrid technique for obtaining vascular hemostasis by combining a suture- and a collagen-mediated system after transfemoral transcatheter aortic valve implantation (TF TAVI) in a real-world setting.

METHODS

In 75 consecutive TF TAVI procedures, we investigated a hybrid closing method to achieve hemostasis at the large bore puncture site using a combination of one presuture closure system (ProGlide) and one collagen-mediated system (Angio-Seal). Vascular complications at puncture site were recorded until discharge.

RESULTS

Successful hemostasis by the hybrid technique was achieved in 74 out of 75 patients, and the method was well tolerated by all patients. In 73 patients, (97.3%) neither puncture site related complications nor serious early or late bleedings were observed during a median hospital stay of 2 days postprocedure.

CONCLUSION

This single-center registry study indicates that a percutaneous hybrid closure technique is safe and efficacious in closing large bore arteriotomies. It is an easy and reliable technique that may contribute to simplifying TAVI procedures.

STUDY REGISTRATION

The data was collected from an internal quality control registry on treatment of patients with valvular heart disease with or without coronary artery disease, No 2014/17280, Oslo University Hospital, Ullevål.

摘要

目的

在真实环境中,经股动脉经导管主动脉瓣置换术(TF TAVI)后,通过联合缝线和胶原介导系统,评估一种混合技术获得血管止血的临床实用性和可行性。

方法

在 75 例连续 TF TAVI 手术中,我们研究了一种混合闭合方法,即在使用一种预置缝线闭合系统(ProGlide)和一种胶原介导系统(Angio-Seal)的情况下,对大口径穿刺部位进行止血。记录穿刺部位的血管并发症,直至出院。

结果

74 例患者采用混合技术成功止血,所有患者均能耐受该方法。在 73 例患者中(97.3%),在术后中位住院时间 2 天内,未观察到与穿刺部位相关的并发症或严重的早期或晚期出血。

结论

这项单中心登记研究表明,经皮混合闭合技术在闭合大口径动脉切开部位是安全有效的。这是一种简单可靠的技术,可能有助于简化 TAVI 手术。

研究注册

该数据来自于一项治疗伴有或不伴有冠状动脉疾病的瓣膜性心脏病患者的内部质量控制登记,登记号为 2014/17280,登记单位为奥斯陆大学医院,乌尔莱瓦。

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