Gerckens U, Cattelaens N, Müller R, Lampe E G, Grube E
Medizinische Klinik, Kardiologie, Krankenhaus Siegburg.
Herz. 1998 Feb;23(1):27-34. doi: 10.1007/BF03043009.
The safety and efficacy of a suture-based closure device designed to achieve hemostasis at the femoral access site post catheterization procedures was compared to manual compression in a 600 patients randomized trial (data available for 590 patients). The patients were randomized to percutaneous vascular surgery (PVS) or manual compression after diagnostic (401 patients) and interventional (189 patients) procedures. Two types of PVS devices were used delivering 1 or 2 sutures at the arterial access site. The overall results as well as the results by procedure type demonstrated a significant reduction in time of hemostasis (7.8 +/- 4.8 min vs 19.6 +/- 13.2 min, p < 0.01) and time to ambulation (4.5 +/- 6.5 hours vs 17.8 +/- 5.0 hours, p < 0.01) with the use of the PVS device. The safety results showed no significant differences in the incidence of vascular complications (5.7% for PVS vs 11.3% for compression) in the overall population or in the interventional patients subset (8.4% for PVS vs 9.6% for compression). However, the PVS device demonstrated a significant reduction in the incidence of vascular complications post diagnostic catheterization procedures (4.4 for PVS vs 12.1% for compression, p < 0.05). The incidence of vascular complications and the time of hemostasis was similar in an American multicenter study (STAND II).
Percutaneous vascular surgery is a safe and effective method to achieve hemostasis post catheterization procedure providing faster hemostasis and ambulation without increasing the rate of complication.
在一项纳入600例患者的随机试验(590例患者有可用数据)中,将一种用于在导管插入术后实现股动脉穿刺部位止血的缝线闭合装置的安全性和有效性与手动压迫进行了比较。患者在诊断性(401例患者)和介入性(189例患者)操作后被随机分为接受经皮血管手术(PVS)或手动压迫。使用了两种类型的PVS装置,在动脉穿刺部位缝合1或2针。总体结果以及按操作类型的结果显示,使用PVS装置可显著缩短止血时间(7.8±4.8分钟对19.6±13.2分钟,p<0.01)和下床活动时间(4.5±6.5小时对17.8±5.0小时,p<0.01)。安全性结果显示,总体人群或介入患者亚组中血管并发症发生率无显著差异(PVS组为5.7%,压迫组为11.3%)。然而,PVS装置在诊断性导管插入术后血管并发症发生率显著降低(PVS组为4.4%,压迫组为12.1%,p<0.05)。在美国一项多中心研究(STAND II)中,血管并发症发生率和止血时间相似。
经皮血管手术是导管插入术后实现止血的一种安全有效的方法,能更快实现止血和下床活动,且不增加并发症发生率。