股动脉血管闭合器的安全性评价  

Safety evaluation of vascular closure devices in femoral artery access

作　　者：刘百球[1] 聂绍平[1] 贾长琪[1] 张崟[1] 吕强[1] 刘新民[1] 董建增[1] 刘小慧[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029

出　　处：《中华老年心脑血管病杂志》2011年第7期598-600,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家重点基础研究发展规划项目973计划基金资助(2003CB517103)

摘　　要：目的评价股动脉血管闭合器(VCDs)的围手术期及中长期安全性。方法连续入选2008年6月～2009年10月接受经股动脉冠状动脉造影和(或)血管成形术的患者1078例,根据治疗方法不同分为压迫止血组(369例)和VCDs组(709例),比较2组围手术期血管并发症发生率;另选2004年3月～2009年10月行髂动脉造影并使用VCDs、术后3个月后再次穿刺同侧股动脉并行髂动脉造影的患者92例,评价VCDs的中长期安全性。结果股动脉穿刺术围手术期血管并发症总发生率为0.7%。与压迫止血组比较,VCDs组围手术期血管并发症明显减少(1.6%vs 0.3%,P=0.039)。logistic回归分析,血管并发症与性别、血压、体重指数使用VCDs和积极抗凝、抗血小板治疗等无关。92例患者中,2次髂动脉造影间隔中位数为232 d,使用VCDs后复查髂动脉造影,狭窄发生率为3.3%,但均无下肢缺血症状。结论 VCDs的围手术期及中长期安全性较高。造影随访发现,使用VCDs后存在一定的狭窄率,但其发生率较低;且无下肢缺血症状。To evaluate the perioperative and mid long term safety performance of vascular closure devices（VCDs） in femoral artery access. Methods 1078 consecutive patients undergoing transfemoral pereutaneous cardiac catheterizations were enrolled from 2008 to 2009. The incidences of perioperative vascular complications between manual compression group and VCDs group were compared. Data of 92 unselected patients undergoing transfemoral percutaneous cardi- ac catheterization from 2004 to 2009 were collectedretrospectively for evaluating mid-long term safety of VCDs. For these patients,hemostasis by VCDs was performed in the first procedure and rechecked by ipsilateral femoral angiography at least 3 months later. The percentage stenosis was utilized to evaluate the mid long term safety performance of VCDs on femoral angiography. Results The overall perioperative incidence of vascular complication was 0.7%. Patients of VCDs group had relatively lower rates of perioperative complications （P = 0. 039） compared with manual compression group. The average interval to femoral angiography recheck was 232 days. Stenosis （ADS≥50%） occurred in 3.30%oo of 92 patients. Conclusions Compared with manual compression group, VCDs group demonstrated more reliable perioperative safety performance. VCDs also showed midlong term safety,but minority of patients presented stenosis of puncture site.

关 键 词：股动脉 血管成形术 血管造影术 手术中并发症 止血 穿刺术 血管闭合器 

分 类 号：R654.3[医药卫生—外科学]