Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Cardiology, Nakatugawa Municipal Hospital, Nakatugawa, Japan.
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Heart Rhythm. 2024 Oct;21(10):2028-2036. doi: 10.1016/j.hrthm.2024.04.041. Epub 2024 Apr 10.
Venous vascular access complications are usually nonfatal but are the most common complications after transvenous catheter intervention. Vascular closure devices (VCDs) have recently become available for venous closure.
This study aimed to evaluate the feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated VCDs in patients who underwent catheter ablation.
This single-center observational study enrolled 226 consecutive patients who underwent elective catheter ablation with femoral venipuncture. For hemostasis, vessel closure by VCD was performed with real-time ultrasound guidance after 2022 (n = 123) and without ultrasound guidance in 2021 (n = 103). The occurrence of venous access site-related complications (major, minor, or other) was compared.
The rate of device failure was significantly lower in patients with ultrasound guidance than in those without (1.6% vs 6.3%; P = .048). The occurrence of all venous access site-related complications was significantly lower in patients with ultrasound guidance than in those without (4.9% vs 18.4%; P = .001). Time to ambulation was shorter in patients with ultrasound guidance than in those without (2.0 ± 0.1 hours vs 2.2 ± 0.6 hours; P < .001).
Real-time ultrasound guidance can reduce device failure, access site-related complications, and time to ambulation in performing venous closure with a VCD.
静脉血管通路并发症通常不会致命，但却是经静脉导管介入治疗后最常见的并发症。血管闭合装置（VCD）最近已可用于静脉闭合。
本研究旨在评估实时超声引导下使用缝线介导的 VCD 行经股静脉穿刺导管消融术患者的静脉闭合的可行性和疗效。
这是一项单中心观察性研究，共纳入 226 例择期行经股静脉穿刺导管消融术的连续患者。2022 年（n = 123）采用实时超声引导 VCD 血管闭合，2021 年（n = 103）未采用超声引导行血管闭合。比较静脉入路部位相关并发症（主要、次要或其他）的发生情况。
与无超声引导组相比，有超声引导组的器械故障发生率显著降低（1.6% vs 6.3%；P =.048）。有超声引导组的所有静脉入路部位相关并发症的发生率均显著低于无超声引导组（4.9% vs 18.4%；P =.001）。有超声引导组的下床活动时间短于无超声引导组（2.0 ± 0.1 小时 vs 2.2 ± 0.6 小时；P <.001）。
实时超声引导可降低 VCD 行静脉闭合时的器械故障、入路部位相关并发症和下床活动时间。
