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大口径静脉通路后缝合闭合(SAFE-VEIN):一种静脉闭合装置有效性和安全性的随机前瞻性研究。

Suture closure AFtEr large bore vein access (SAFE-VEIN): A randomized, prospective study of the efficacy and safety of venous closure device.

机构信息

Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care, Milwaukee, Wisconsin, USA.

Academic Affairs, Cardiovascular Research, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care, Milwaukee, Wisconsin, USA.

出版信息

Catheter Cardiovasc Interv. 2024 Oct;104(4):820-828. doi: 10.1002/ccd.31173. Epub 2024 Aug 1.

Abstract

BACKGROUND

Perclose ProGlide (PPG) Suture-Mediated Closure System™ is safe and can reduce time to hemostasis following procedures requiring arterial access.

AIMS

We aimed to compare PPG to figure of 8 suture in patients who underwent interventional catheter procedures requiring large bore venous access (LBVA) (≥13 French).

METHODS

In this physician-initiated, randomized, single-center study [clinicaltrials.gov ID: NCT04632641], single-stick venous access was obtained under ultrasound guidance. Eligible patients were randomized 1:1, and 100 subjects received allocated treatment to either PPG (n = 47) or figure of 8 suture (n = 53). No femoral arterial access was used in any patient. Primary outcomes were time to achieve hemostasis (TTH) and time to ambulation (TTA). Secondary outcomes were time to discharge (TTD) and vascular-related complications and mortality. Wilcoxon rank-sum test was used to compare TTH, TTA, and TTD.

RESULTS

TTH (minutes) was significantly lower in PPG versus figure of 8 suture [median, (Q1, Q3)] [7 (2,10) vs. 11 (10,15) respectively, p < 0.001]. TTA (minutes) was significantly lower in PPG compared to figure of 8 suture [322 (246,452) vs. 403 (353, 633) respectively, p = 0.005]. TTD (minutes) was not significantly different between the PPG and figure of 8 suture arms [1257 (1081, 1544) vs. 1338 (1171,1435), p = 0.650]. There was no difference in minor bleeding or access site hematomas between both arms. No other vascular complications or mortality were reported.

CONCLUSION

PPG use had lower TTH and TTA than figure of 8 suture in a population of patients receiving LBVA procedures. This may encourage same-day discharge in these patients.

摘要

背景

Perclose ProGlide(PPG)缝合介导闭合系统™安全,可减少需要动脉入路的介入导管程序后止血时间。

目的

我们旨在比较 PPG 与 8 字缝合在接受大口径静脉入路(LBVA)(≥13 French)介入导管程序的患者中的效果。

方法

在这项由医师发起的、随机的、单中心研究[临床试验.gov ID:NCT04632641]中,在超声引导下获得单针静脉入路。符合条件的患者按 1:1 随机分组,100 例患者接受分配的治疗,PPG(n=47)或 8 字缝合(n=53)。在任何患者中均未使用股动脉入路。主要结局是达到止血的时间(TTH)和开始行走的时间(TTA)。次要结局是出院时间(TTD)和血管相关并发症及死亡率。采用 Wilcoxon 秩和检验比较 TTH、TTA 和 TTD。

结果

PPG 组 TTH(分钟)明显低于 8 字缝合组[中位数(Q1,Q3)][7(2,10)比 11(10,15),p<0.001]。PPG 组 TTA(分钟)明显低于 8 字缝合组[322(246,452)比 403(353,633),p=0.005]。PPG 组与 8 字缝合组 TTD(分钟)无显著差异[1257(1081,1544)比 1338(1171,1435),p=0.650]。两组间轻微出血或穿刺部位血肿无差异。未报告其他血管并发症或死亡率。

结论

在接受 LBVA 程序的患者人群中,PPG 组的 TTH 和 TTA 低于 8 字缝合组。这可能鼓励这些患者当日出院。

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