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单Angio-Seal™装置作为经皮门静脉穿刺通道闭合的一种简化且技术可行的替代方法:一项回顾性研究

Single Angio-Seal™ Device as a Simplified and Technically Feasible Alternative for Tract Closure in Percutaneous Portal Vein Access: A Retrospective Study.

作者信息

Karluka Ismail, Mazıcan Mustafa

机构信息

Department of Interventional Radiology, Adana Dr. Turgut Noyan Application and Research Center, Baskent University, Adana 01250, Turkey.

出版信息

Diagnostics (Basel). 2025 May 16;15(10):1266. doi: 10.3390/diagnostics15101266.

Abstract

This study aimed to evaluate the efficacy and safety of the Angio-Seal™ VIP vascular closure device (VCD) in achieving hemostasis following percutaneous transhepatic portal venous interventions. This retrospective study evaluated 20 patients (mean age: 52.85 ± 16.18 years; 80% male) who underwent percutaneous transhepatic portal vein interventions followed by tract closure with the Angio-Seal™ device between January 2016 and September 2024. Procedural data, pre- and post-procedural hemoglobin and hematocrit levels, and complications were analyzed. Technical success was defined as the successful deployment of the device with immediate hemostasis and no evidence of bleeding on post-procedural imaging. Technical success, as defined in this study, was achieved in all 20 procedures (100%). The mean hemoglobin level declined from 11.91 ± 2.01 g/dL to 11.09 ± 2.19 g/dL ( < 0.001), and the mean hematocrit level decreased from 36.18 ± 6.03% to 32.98 ± 5.80% ( = 0.001). A hemoglobin drop ≥2 g/dL occurred in two patients (10%) and a hematocrit drop ≥4% in six patients (30%); none were associated with imaging or clinical evidence of hemorrhage. No major complications were observed. Minor complications, including localized pain managed with analgesics, occurred in five patients (25%). Follow-up imaging confirmed the absence of hemoperitoneum or device-related failure. Angio-Seal™ is a technically feasible, safe, and effective option for tract closure following percutaneous transhepatic portal vein access. This single-device approach may offer a cost-effective alternative to traditional embolization techniques. However, more extensive prospective studies are required to validate these findings.

摘要

本研究旨在评估Angio-Seal™ VIP血管闭合装置(VCD)在经皮经肝门静脉介入术后实现止血的有效性和安全性。这项回顾性研究评估了20例患者(平均年龄:52.85±16.18岁;80%为男性),这些患者在2016年1月至2024年9月期间接受了经皮经肝门静脉介入术,随后使用Angio-Seal™装置封闭穿刺通道。分析了手术数据、术前和术后血红蛋白及血细胞比容水平以及并发症。技术成功定义为装置成功部署并立即止血,且术后影像学检查无出血迹象。本研究定义的技术成功在所有20例手术中均实现(100%)。平均血红蛋白水平从11.91±2.01 g/dL降至11.09±2.19 g/dL(P<0.001),平均血细胞比容水平从36.18±6.03%降至32.98±5.80%(P = 0.001)。两名患者(10%)血红蛋白下降≥2 g/dL,六名患者(30%)血细胞比容下降≥4%;均与出血的影像学或临床证据无关。未观察到重大并发症。五名患者(25%)出现轻微并发症,包括用镇痛药处理的局部疼痛。随访影像学检查证实无腹腔积血或与装置相关的故障。Angio-Seal™是经皮经肝门静脉穿刺通道封闭的一种技术上可行、安全且有效的选择。这种单一装置方法可能为传统栓塞技术提供一种经济有效的替代方案。然而,需要更广泛的前瞻性研究来验证这些发现。

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