Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Critical Care Division, Rambam Health Care Campus, Haifa, Israel.
Angiology. 2022 Aug;73(7):635-642. doi: 10.1177/00033197211058498. Epub 2022 Feb 11.
Reliable femoral artery closure devices are essential for the success of trans-femoral Transcatheter Aortic Valve Implantation (TAVI) procedures. Accordingly, device choice might affect vascular complications and bleeding rates. This was a retrospective analysis, comparing vascular complication rates among patients who underwent trans-femoral TAVI with vascular access closure using either the ProGlide parallel suture or Prostar closure devices. We included 191 patients: 106 were treated with Prostar and 85 with ProGlide. The ProGlide group had higher rate of diabetes, chronic kidney disease, peripheral arterial disease, and significantly smaller femoral arteries that were treated via larger sheaths. Valve Academic Research Consortium (VARC)-2 major complications were similar between the groups. (4.7% for ProGlide vs 3.8% for Prostar, P=1), with similar incidence of closure device failure (2 vs 3, P=1). No differences were found after univariant analysis and propensity-score matching in the incidence of major and minor bleeding nor in the rate of in-hospital mortality between ProGlide and Prostar (4.7 vs 2.8%, P=.7, 1.2 vs 2.8%, P=.63, and 1.2 vs .0%, P=.45, respectively). Parallel suture technique using two ProGlide sutures showed comparable rates of vascular complications to the Prostar closure device in higher risk population of TAVI patients.
可靠的股动脉闭合装置对于经股动脉经导管主动脉瓣植入术(TAVI)的成功至关重要。因此,器械的选择可能会影响血管并发症和出血率。这是一项回顾性分析,比较了使用 ProGlide 平行缝线或 Prostar 闭合装置进行经股动脉 TAVI 的患者的血管并发症发生率。我们纳入了 191 名患者:106 名患者接受 Prostar 治疗,85 名患者接受 ProGlide 治疗。ProGlide 组糖尿病、慢性肾脏病、外周动脉疾病的发生率较高,股动脉较小,需要使用较大的鞘管进行治疗。两组的 Valve Academic Research Consortium(VARC)-2 主要并发症相似。(ProGlide 为 4.7%,Prostar 为 3.8%,P=1),闭合装置失效的发生率相似(2 例对 3 例,P=1)。单变量分析和倾向评分匹配后,ProGlide 和 Prostar 之间的主要和次要出血发生率以及住院死亡率均无差异(ProGlide 为 4.7%对 2.8%,P=.7,1.2%对 2.8%,P=.63,1.2%对 0%,P=.45)。使用两根 ProGlide 缝线的平行缝合技术在 TAVI 患者的高危人群中显示出与 Prostar 闭合装置相当的血管并发症发生率。