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经皮静脉-动脉体外膜肺氧合中用于血管止血的新型经皮闭合技术的发明

Invention of a new percutaneous closure technique for vascular haemostasis in percutaneous veno-arterial extracorporeal membrane oxygenation.

作者信息

Guanqiang Li, Bo Hu, Yuan Sun, Ming Chen, Xicheng Zhang, Xianchen Huang

机构信息

The Fourth Affiliated Hospital of Soochow University, 9 ChongWen Road, Suzhou Industrial Park, Suzhou City, Jiangsu Province, China.

出版信息

Eur J Med Res. 2025 Feb 19;30(1):119. doi: 10.1186/s40001-025-02307-x.

Abstract

OBJECTIVE

To assess the feasibility and safety of a novel closure technique, namely the parallel closure technique (Par-CT), in which the sheath is placed parallel to the ProGlide system during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to enhance the efficiency of percutaneous vascular haemostasis.

METHODS

The abdominal aortas of goats were punctured with a 17F sheath to simulate arterial cannula vascular access for VA-ECMO, and the Par-CT was used to achieve vascular haemostasis. In five goats, the abdominal aorta was punctured with a 17F sheath and then a 6 to 10F vascular sheath was introduced. This resulted in a smaller vascular rupture area and successful closure of the aortic rupture using the Par-CT.

RESULTS

If the sheath tube that was introduced was < 8 F, the puncture site could not be closed and would therefore have to be resutured and the Par-CT would have to be repeated. However, the puncture site could be sutured appropriately if the sheath tube that was introduced was ≥ 8F.

CONCLUSIONS

This study suggested that the Par-CT is both safe and effective for haemostasis after weaning from VA-ECMO.

摘要

目的

评估一种新型闭合技术,即平行闭合技术(Par-CT)的可行性和安全性,该技术是在静脉-动脉体外膜肺氧合(VA-ECMO)期间将鞘管与ProGlide系统平行放置,以提高经皮血管止血效率。

方法

用17F鞘管穿刺山羊腹主动脉,模拟VA-ECMO的动脉插管血管通路,采用Par-CT实现血管止血。在5只山羊中,先用17F鞘管穿刺腹主动脉,然后置入6至10F血管鞘管。这导致较小的血管破裂面积,并使用Par-CT成功闭合主动脉破裂处。

结果

如果置入的鞘管<8F,则穿刺部位无法闭合,因此必须重新缝合,并重复Par-CT。然而,如果置入的鞘管≥8F,则穿刺部位可适当缝合。

结论

本研究表明,Par-CT在VA-ECMO撤机后止血方面安全有效。

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