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股动脉大口径鞘管管理：从血管穿刺到鞘管移除，如何预防血管并发症。

Femoral Large Bore Sheath Management: How to Prevent Vascular Complications From Vessel Puncture to Sheath Removal.

机构信息

Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta).

Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy (F. Bianchini, E.B., A.Z., C.T., F. Burzotta).

出版信息

Circ Cardiovasc Interv. 2024 Sep;17(9):e014156. doi: 10.1161/CIRCINTERVENTIONS.124.014156. Epub 2024 Aug 21.

DOI:10.1161/CIRCINTERVENTIONS.124.014156
PMID:39166330
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404769/
Abstract

Transfemoral access is nowadays required for an increasing number of percutaneous procedures, such as structural heart interventions, mechanical circulatory support, and interventional electrophysiology/pacing. Despite technological advancements and improved techniques, these devices necessitate large-bore (≥12 French) arterial/venous sheaths, posing a significant risk of bleeding and vascular complications, whose occurrence has been related to an increase in morbidity and mortality. Therefore, optimizing large-bore vascular access management is crucial in endovascular interventions. Technical options, including optimized preprocedural planning and proper selection and utilization of vascular closure devices, have been developed to increase safety. This review explores the comprehensive management of large-bore accesses, from optimal vascular puncture to sheath removal. It also discusses strategies for managing closure device failure, with the goal of minimizing vascular complications.

摘要

经股动脉入路如今越来越多地应用于各种经皮介入操作，如结构性心脏病介入治疗、机械循环支持以及心脏电生理/起搏介入治疗。尽管技术不断进步和方法不断改进，但这些器械需要使用大口径（≥12 French）的动脉/静脉鞘管，这会带来严重的出血和血管并发症风险，其发生与发病率和死亡率的增加有关。因此，优化大口径血管入路管理在血管内介入治疗中至关重要。已经开发了一些技术选择，包括优化术前规划以及适当选择和使用血管闭合装置，以提高安全性。这篇综述探讨了大口径入路的综合管理，从最佳血管穿刺到鞘管拔出。它还讨论了处理闭合装置失败的策略，目标是最小化血管并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/418b0c8109de/hcv-17-e014156-g008.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/4f6056e04866/hcv-17-e014156-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/2d0f05479288/hcv-17-e014156-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/58ce307d1e22/hcv-17-e014156-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/418b0c8109de/hcv-17-e014156-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/b37683addb17/hcv-17-e014156-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/5361de703e93/hcv-17-e014156-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/81a5b1126a6b/hcv-17-e014156-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/4f6056e04866/hcv-17-e014156-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/2d0f05479288/hcv-17-e014156-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/58ce307d1e22/hcv-17-e014156-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d2/11404769/418b0c8109de/hcv-17-e014156-g008.jpg

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Comparison of ultrasound- versus fluoroscopy-guidEd femorAl access In tranS-catheter aortic valve replacement In the Era of contempoRary devices: The EASIER registry.超声引导与透视引导经导管主动脉瓣置换术在当代器械时代的比较：EASIER 注册研究。
Cardiovasc Revasc Med. 2024 May;62:40-47. doi: 10.1016/j.carrev.2023.12.007. Epub 2023 Dec 16.
3
A systematic algorithm for large-bore arterial access closure after TAVI: the TAVI-MultiCLOSE study.
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Ultrasound guidance for transfemoral access in coronary procedures: an individual participant-level data metaanalysis from the femoral ultrasound trialist collaboration.超声引导经股动脉入路在冠状动脉介入治疗中的应用：来自股动脉超声试验者协作的个体参与者水平数据荟萃分析。
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5
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JACC Cardiovasc Interv. 2023 Sep 25;16(18):2262-2274. doi: 10.1016/j.jcin.2023.07.005. Epub 2023 Sep 6.
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