Liu Zhenjie, Xu Yongshan, Xu Xin, He Minzhi, Han Pan, Shao Changming, Pan Yifeng, Zhang Libin, Yin Li, Li Zhenhua, Huang Man, Chen Bing
Department of Vascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Front Med (Lausanne). 2021 Aug 20;8:724427. doi: 10.3389/fmed.2021.724427. eCollection 2021.
Total percutaneous closure for the site of femoral arterial puncture using Perclose ProGlide (PP) has become prevalent post-percutaneous endovascular aortic repair (EVAR) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). To evaluate the safety and efficacy of total percutaneous closure of the femoral artery access site post-EVAR compared with VA-ECMO. This was a retrospective observational study conducted over 4 years, including 88 patients who underwent EVAR (64 patients) and VA-ECMO (24 patients). Perclose ProGlide devices were used in the femoral artery puncture sites closed percutaneously. In this study, technical success was defined as successful arterial closure of the common femoral artery (CFA) without additional surgical or endovascular procedures to prevent vessel leaking. Access site complications, including overt bleeding requiring transfusion or surgical intervention, minor bleeding, tinea cruris, pseudoaneurysm, and lymphocele, were recorded 24 h and 30 days after arterial closure. Each group's technical success rates were 95.8% (VA-ECMO) and 92.2% EVAR, respectively. There were no differences in the periprocedural complications of major bleeding, pseudoaneurysm, minor bleeding, acute limb ischemia, and groin infection. Furthermore, we did not observe any complications such as arterial thrombosis, dissection, stenosis, arteriovenous fistula, hematoma, groin infection, or lymphocele at the access site by following-up an ultrasound examination. There was no significant difference in the technical success rate of percutaneous closure by the PP device in the EVAR and VA-ECMO oxygenation groups. Also, no periprocedural or 30-day complications were observed at the access site of the EVAR and VA-ECMO patients.
使用Perclose ProGlide(PP)对股动脉穿刺部位进行完全经皮闭合,在经皮血管腔内主动脉修复术(EVAR)和静脉-动脉体外膜肺氧合(VA-ECMO)后已变得普遍。为了评估与VA-ECMO相比,EVAR后股动脉穿刺部位完全经皮闭合的安全性和有效性。这是一项为期4年的回顾性观察研究,包括88例行EVAR的患者(64例)和VA-ECMO的患者(24例)。Perclose ProGlide装置用于经皮闭合的股动脉穿刺部位。在本研究中,技术成功定义为股总动脉(CFA)成功实现动脉闭合,无需额外的手术或血管腔内操作来预防血管渗漏。在动脉闭合后24小时和30天记录穿刺部位并发症,包括需要输血或手术干预的明显出血、轻微出血、股癣、假性动脉瘤和淋巴囊肿。每组的技术成功率分别为95.8%(VA-ECMO)和92.2%(EVAR)。围手术期主要出血、假性动脉瘤、轻微出血、急性肢体缺血和腹股沟感染的并发症无差异。此外,通过超声检查随访,我们未观察到穿刺部位有任何诸如动脉血栓形成、夹层、狭窄、动静脉瘘、血肿、腹股沟感染或淋巴囊肿等并发症。EVAR和VA-ECMO氧合组中,PP装置经皮闭合的技术成功率无显著差异。此外,在EVAR和VA-ECMO患者的穿刺部位未观察到围手术期或30天并发症。