Zako Saif, Naguib David, Klein Kathrin, Öz Asena, Helten Carolin, Mourikis Philipp, Metzen Daniel, Kelm Malte, Zeus Tobias, Polzin Amin
Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany.
J Invasive Cardiol. 2025 Sep;37(9). doi: 10.25270/jic/25.00021.
Venous access plays a crucial role in various interventional cardiology procedures, including percutaneous patent foramen ovale (PFO) closure. Traditionally, manual compression has been the standard method for achieving hemostasis following venous access. However, this approach may be associated with potential complications such as puncture site bleedings. The aim of the study was to compare the safety and efficacy of different venous closure techniques.
The authors conducted a single-center observational study of 220 patients undergoing PFO closure. The study quasi-randomized participants to 1 of 3 methods: Z-suture closure, Perclose ProGlide suture-mediated closure (Abbott), and manual compression. The primary outcome was the occurrence of bleeding events, classified according to the standardized Bleeding Academic Research Consortium (BARC) classification system.
Bleeding events were not significantly different between the closure groups. Of the patients who received manual compression, 14.2% (n = 17) experienced BARC bleeding events of 2 or higher. In the Z-suture group, 14.5% (n = 7) of patients had BARC bleeding events of 2 or higher. In the ProGlide group, 15% (n = 8) of patients experienced such events (P = .9). Only 1 patient in the manual compression group experienced a severe bleeding event (BARC 3). However, no cases of BARC 4 or 5 occurred in any of the closure groups.
The Z-suture and ProGlide methods are safe and efficient for venous occlusion after percutaneous PFO closure compared with manual compression.
静脉通路在包括经皮卵圆孔未闭（PFO）封堵术在内的各种介入心脏病学手术中起着至关重要的作用。传统上，手动压迫一直是静脉通路后实现止血的标准方法。然而，这种方法可能会伴有潜在并发症，如穿刺部位出血。本研究的目的是比较不同静脉闭合技术的安全性和有效性。
作者对220例接受PFO封堵术的患者进行了单中心观察性研究。该研究将参与者半随机分为3种方法中的1种：Z形缝合闭合、Perclose ProGlide缝线介导闭合（雅培公司）和手动压迫。主要结局是出血事件的发生情况，根据标准化的出血学术研究联盟（BARC）分类系统进行分类。
各闭合组之间出血事件无显著差异。在接受手动压迫的患者中，14.2%（n = 17）发生了BARC 2级或更高等级的出血事件。在Z形缝合组中，14.5%（n = 7）的患者发生了BARC 2级或更高等级的出血事件。在ProGlide组中，15%（n = 8）的患者发生了此类事件（P = 0.9）。手动压迫组中只有1例患者发生了严重出血事件（BARC 3级）。然而，在任何一个闭合组中均未发生BARC 4级或5级病例。
与手动压迫相比，Z形缝合和ProGlide方法在经皮PFO封堵术后静脉闭塞方面是安全有效的。
