Sohal Sumit, Mathai Sheetal Vasundara, Nagraj Sanjana, Kurpad Krishna, Suthar Kandarp, Mehta Harsh, Kaur Komaldeep, Wasty Najam, Waxman Sergio, Cohen Marc, Visveswaran Gautam K, Tayal Rajiv
Division of Cardiology, Department of Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112, USA.
Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, New York, NY 10461, USA.
J Cardiovasc Dev Dis. 2022 Sep 30;9(10):331. doi: 10.3390/jcdd9100331.
Large bore access procedures rely on vascular closure devices to minimize access site complications. Suture-based vascular closure devices (S-VCD) such as ProGlide and ProStar XL have been readily used, but recently, newer generation collagen-based vascular closure devices (C-VCD) such as MANTA have been introduced. Data on comparisons of these devices are limited.
PubMed, Scopus and Cochrane were searched for articles on vascular closure devices using keywords, ("Vascular closure devices" OR "MANTA" OR "ProStar XL" OR "ProGlide") AND ("outcomes") that resulted in a total of 875 studies. Studies were included if bleeding or vascular complications as defined by Valve Academic Research Consortium-2 were compared between the two types of VCDs. The event level data were pooled across trials to calculate the Odds Ratio (OR) with 95% CI, and analysis was done with Review Manager 5.4 using random effects model.
Pooled analyses from these nine studies resulted in a total of 3410 patients, out of which 2855 were available for analysis. A total of 1229 received C-VCD and 1626 received S- VCD. Among the patients who received C-VCD, the bleeding complications (major and minor) were similar to patients who received S-VCD ((OR: 0.70 (0.35-1.39), = 0.31, I = 55%), OR: 0.92 (0.53-1.61), = 0.77, I = 65%)). The vascular complications (major and minor) in patients who received C-VCD were also similar to patients who received S-VCD ((OR: 1.01 (0.48-2.12), = 0.98, I = 52%), (OR: 0.90 (0.62-1.30), = 0.56, I = 35%)).
Bleeding and vascular complications after large bore arteriotomy closure with collagen-based vascular closure devices are similar to suture-based vascular closure devices.
大口径血管穿刺操作依赖血管闭合装置以尽量减少穿刺部位并发症。基于缝线的血管闭合装置（S-VCD），如ProGlide和ProStar XL已被广泛使用，但最近，新一代基于胶原蛋白的血管闭合装置（C-VCD），如MANTA已被引入。关于这些装置比较的数据有限。
在PubMed、Scopus和Cochrane数据库中检索使用关键词（“血管闭合装置”或“MANTA”或“ProStar XL”或“ProGlide”）和（“结果”）的关于血管闭合装置的文章，共检索到875项研究。如果比较了两种类型的血管闭合装置之间根据瓣膜学术研究联盟-2定义的出血或血管并发症，则纳入这些研究。将各试验中的事件水平数据进行合并，以计算比值比（OR）及95%置信区间，并使用随机效应模型通过Review Manager 5.4进行分析。
这9项研究的汇总分析共纳入3410例患者，其中2855例可用于分析。共有1229例接受C-VCD，1626例接受S-VCD。在接受C-VCD的患者中，出血并发症（主要和次要）与接受S-VCD的患者相似（（OR：0.70（0.35 - 1.39），P = 0.31，I² = 55%），OR：0.92（0.53 - 1.61），P = 0.77，I² = 65%））。接受C-VCD的患者的血管并发症（主要和次要）也与接受S-VCD的患者相似（（OR：1.01（0.48 - 2.12），P = 0.98，I² = 52%），（OR：0.90（0.62 - 1.30），P = 0.56，I² = 35%））。
使用基于胶原蛋白的血管闭合装置进行大口径动脉切开闭合术后的出血和血管并发症与基于缝线的血管闭合装置相似。
