Gagnon Cardiovascular Institute, Morristown Medical Center, 100 Madison Avenue, Morristown, NJ 07960 USA.
J Invasive Cardiol. 2020 Jul;32(7):255-261. doi: 10.25270/jic/20.00303. Epub 2020 Jun 8.
To evaluate the safety and accuracy of the Early Bird Bleed Monitoring System (EBBMS; Saranas) for the detection of access-site related bleeds in humans undergoing endovascular procedures.
Bleeding complications after endovascular procedures are frequent and associated with poor prognosis. The EBBMS is a novel technology designed to detect in real time the onset, progression, and severity of internal bleeds.
The EBBMS was used during and after endovascular procedures, either as a venous or arterial access sheath. The primary endpoint was the level of agreement in bleed detection between the Saranas EBBMS and postprocedural computed tomography.
From August 2018 to December 2018, a total of 60 patients from five United States sites were enrolled and underwent elective endovascular procedures (transcatheter aortic valve replacement [67%], percutaneous coronary intervention [13%], percutaneous ventricular assist device [8%], balloon aortic valvuloplasty [7%], transcatheter mitral valve repair/replacement [4%], and endovascular aneurysmal repair [2%]). The EBBMS detected the absence of bleeds in 21 patients (35%) and bleeds in 39 patients (65%), with bleeding severity level 1 in 20 patients (33%), level 2 in 15 patients (25%), and level 3 in 4 patients (7%). Bleeding detection occurred during the procedure in 31% of patients and post procedure in 69% of patients. The level of agreement between the EBBMS and computed tomography scan was high (Cohen's kappa=0.84). No device-related complications were reported.
The EBBMS was safe across a variety of endovascular procedures and detected bleeding events with a high level of agreement with postprocedural computed tomography scan.
评估 Early Bird Bleed Monitoring System(EBBMS;Saranas)用于检测人类血管内程序中血管入路相关出血的安全性和准确性。
血管内手术后出血并发症频繁,且与预后不良相关。EBBMS 是一种新型技术,旨在实时检测内部出血的发生、进展和严重程度。
EBBMS 在血管内程序期间和之后用于静脉或动脉入路护套。主要终点是 Saranas EBBMS 与术后计算机断层扫描在出血检测方面的一致性水平。
2018 年 8 月至 2018 年 12 月,来自美国五个地点的 60 名患者入选并接受了选择性血管内程序(经导管主动脉瓣置换术 [67%]、经皮冠状动脉介入治疗 [13%]、经皮心室辅助装置 [8%]、球囊主动脉瓣成形术 [7%]、经导管二尖瓣修复/置换 [4%] 和血管内动脉瘤修复 [2%])。EBBMS 在 21 名患者(35%)中检测到无出血,在 39 名患者(65%)中检测到出血,20 名患者(33%)为出血严重程度 1 级,15 名患者(25%)为出血严重程度 2 级,4 名患者(7%)为出血严重程度 3 级。出血检测发生在 31%的患者的手术过程中,69%的患者的术后。EBBMS 与计算机断层扫描之间的一致性水平较高(Cohen's kappa=0.84)。未报告与器械相关的并发症。
EBBMS 在多种血管内程序中是安全的,并且与术后计算机断层扫描检测出血事件具有高度一致性。