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外周动脉介入治疗的血管入路和闭合

Vascular Access and Closure for Peripheral Arterial Intervention.

机构信息

Division of Cardiovascular Medicine, University of Nebraska Medical Center, 982265 Nebraska Medical Center, Omaha, NE 68198, USA.

Division of Cardiovascular Medicine, Harvard Medical School, Boston, MA, USA.

出版信息

Interv Cardiol Clin. 2020 Apr;9(2):117-124. doi: 10.1016/j.iccl.2019.11.001. Epub 2020 Jan 31.

Abstract

Peripheral arterial interventions require safe and effective vascular access and closure. The sites, techniques, and equipment used may vary depending on patient and procedural factors. To minimize the risk of procedural complications, arterial access should use micropuncture technique, ultrasound and fluoroscopic guidance, a compressible arterial access site, and the smallest diameter sheath necessary. Hemostasis at an arteriotomy site may be achieved by manual compression, device-mediated compression, an intravascular closure device, or an extravascular closure device. Although closure devices improve patient comfort and expedite hemostasis, they have not been shown to reduce complications in comparison with compression.

摘要

外周动脉介入治疗需要安全有效的血管入路和闭合。根据患者和手术因素的不同,使用的部位、技术和设备可能会有所不同。为了最大限度地降低手术并发症的风险,动脉入路应采用微穿刺技术、超声和荧光透视引导、可压缩的动脉入路部位和必要的最小直径鞘管。动脉切开部位的止血可以通过手动压迫、器械介导的压迫、血管内闭合装置或血管外闭合装置来实现。虽然闭合装置可以提高患者的舒适度并加快止血,但与压迫相比,它们并不能降低并发症的发生。

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