Kallmes D F, McGraw J K, Li S T, Lin H B, Evans A J, Cloft H J, Matsumoto A H
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
J Vasc Interv Radiol. 1998 Jul-Aug;9(4):656-9. doi: 10.1016/s1051-0443(98)70339-2.
To evaluate in a swine model the hemostatic properties of a new, expansile type I collagen plug for use in high-risk renal biopsies.
Highly purified bovine type I collagen was formed into porous cylindrical plugs and compressed radially to fit into a 5-F delivery system. On hydration these collagen plugs demonstrated radial expansion with approximately 1,600% volumetric expansion ratio. Direct exposure of both kidneys was performed in a 25-kg swine, and a bolus of 3,000 U of heparin was administered to create a coagulopathic state. A 14-gauge Temno coaxial biopsy gun was utilized in performing nine pairs of renal biopsies. The first biopsy of each biopsy pair represented the control biopsy (without collagen plug placement), whereas the second biopsy of each pair represented the plugged biopsy. The presence and duration of hemorrhage from each biopsy site was monitored visually.
The biopsy sites without collagen plug showed immediate hemorrhage in nine of nine cases (100%), and in two of nine cases (22%) pulsatile bleeding was noted. With the use of the collagen plug, seven of nine (78%) sites showed immediate hemorrhage, but in no case was pulsatile bleeding noted. Mean bleeding duration was 156 seconds for the control biopsies versus 73 seconds for the biopsy sites plugged with collagen (P = .03, Mann-Whitney rank sum test). Bleeding duration was less than 1 minute in only one of nine (11%) control biopsies compared to six of nine (67%) collagen plug biopsies.
A recently developed, expansile collagen hemostatic plug significantly decreases the duration of hemorrhage at renal biopsy sites in an anticoagulated swine model.
在猪模型中评估一种用于高风险肾活检的新型可膨胀I型胶原塞的止血性能。
将高度纯化的牛I型胶原制成多孔圆柱形塞，并径向压缩以适合5F输送系统。水化后，这些胶原塞表现出径向膨胀，体积膨胀率约为1600%。在一只25千克的猪身上直接暴露双侧肾脏，并给予3000单位肝素推注以造成凝血障碍状态。使用14号Temno同轴活检枪进行9对肾活检。每对活检中的第一次活检为对照活检（未放置胶原塞），而每对中的第二次活检为放置胶原塞的活检。肉眼观察每个活检部位的出血情况及持续时间。
未放置胶原塞的活检部位在9例中有9例（100%）立即出血，9例中有2例（22%）出现搏动性出血。使用胶原塞后，9例中有7例（78%）部位立即出血，但无一例出现搏动性出血。对照活检的平均出血持续时间为156秒，而放置胶原塞的活检部位为73秒（P = 0.03，Mann-Whitney秩和检验）。9例对照活检中只有1例（11%）出血持续时间少于1分钟，而9例放置胶原塞的活检中有6例（67%）出血持续时间少于1分钟。
一种新开发的可膨胀胶原止血塞在抗凝猪模型中显著缩短了肾活检部位的出血持续时间。
