经皮血管内治疗 Angio-Seal 相关血管闭塞。

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2024-10-27 DOI:10.1002/ccd.31272
Dan Haberman, Evan Czulada, Lior Lupu, Kalyan R Chitturi, Abhishek Chaturvedi, Waiel Abusnina, Ilan Merdler, Pavan Reddy, Itsik Ben-Dor, Lowell F Satler, Ron Waksman, Nelson L Bernardo
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引用次数: 0

摘要

背景:使用血管闭合器(VCD)实现股动脉入路后快速安全止血已被广泛接受。主要并发症包括装置失效导致的股动脉出血和闭塞,因此往往需要进行血管介入治疗。本手稿详细介绍了我们采用外周经皮血管内介入治疗(PEI)方法治疗 Angio-Seal(Terumo,美国新泽西州萨默塞特市)VCD 部署导致的股动脉闭塞:方法:对连续接受 Angio-Seal 敷设术后出现闭塞并发症的患者进行 PEI 治疗,以克服特定并发症。对患者的临床和手术特征以及短期和长期随访数据进行了分析:研究队列包括 40 名在 2013 年 7 月至 2023 年 9 月期间出现 Angio-Seal 闭塞并发症的患者。患者平均年龄为 74 ± 10 岁,55% 为女性。所有患者均接受了 PEI 治疗,总体手术成功率为 100%。35 例患者(88%)采用定向粥样斑块切除术进行 PEI 治疗,其次是球囊治疗,5 例患者(13%)采用切割球囊治疗。只有 7 名患者(18%)将支架植入术作为最终疗法。没有观察到手术并发症或转为手术的情况。在中位随访244天(IQR = 100-707)期间,没有一名患者因Angio-Seal闭塞和抢救介入而需要再次介入治疗:结论:在治疗与 Angi-Seal VCD 相关的股动脉闭塞时,辅助使用定向动脉粥样硬化切除术和球囊血管成形术既有效又安全,可以重建血流,并取得良好的长期疗效。
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Percutaneous endovascular management of Angio-Seal related vascular occlusion.

Background: The use of vascular closure devices (VCDs) to achieve quick and safe hemostasis after femoral arterial access is widely accepted. Major complications include bleeding and occlusion of the femoral artery due to device failure, which often necessitates vascular intervention. This manuscript details our peripheral percutaneous endovascular interventional (PEI) approach for the management of femoral artery occlusion resulting from Angio-Seal (Terumo, Somerset, New Jersey, USA) VCD deployment.

Methods: Consecutive patients who developed occlusive complications after Angio-Seal deployment underwent PEI to overcome specific complications. Patients' clinical and procedural characteristics, along with their short- and long-term follow-up data, were analyzed.

Results: The study cohort included 40 patients who experienced Angio-Seal occlusive complications between July 2013 and September 2023. The mean age of the patients was 74 ± 10 years and 55% were female. All the patients were treated with PEI, with an overall procedural success rate of 100%. The primary approach for PEI was directional atherectomy, which was used in 35 cases (88%), followed by balloon, while a cutting balloon was used in 5 patients (13%). Stenting served as the definitive therapy in only 7 patients (18%). No procedural complications or conversions to surgery were observed. During a median follow-up of 244 (IQR = 100-707) days, none of the patients required re-intervention related to Angio-Seal occlusion and salvage intervention.

Conclusion: In the management of Angi-Seal VCD-related femoral artery occlusion, the adjunctive use of directional atherectomy followed by balloon angioplasty was effective and safe, allowing re-establishment of flow with excellent long-term outcomes.

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来源期刊
CiteScore
5.40
自引率
8.70%
发文量
419
审稿时长
2 months
期刊介绍: Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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