Perclose Proglide血管缝合器在髂动脉显著扭曲患者中的应用

Application of Perclose Proglide vascular closure devices in patients with marked distortion of iliac artery

目的回顾性地分析第三代血管缝合器Perclose Proglide在经股动脉行冠状动脉造影时存在显著髂动脉扭曲的患者中的应用。方法 2005年8月至2007年12月期间经股动脉行冠状动脉造影的3760例患者中,入选髂动脉显著扭曲患者共80例,均需用0.038"泥鳅导丝和(或)23cm长鞘才能完成冠状动脉造影术。手术结束时其中35例按产品说明进行血管缝合术,另外45例按传统手工压迫法止血。观察两组间止血成功率、出血血肿、假性动脉瘤及感染发生率的差异。结果行血管缝合术的患者缝合成功率100%,并发血肿2例,术后出血1例,无假性动脉瘤及感染发生,与手工压迫组相比无明显差异。结论对于髂动脉显著扭曲的患者,在冠状动脉造影结束拔鞘止血时,如无使用血管缝合器的其他禁忌,可安全而有效地进行Perclose Proglide血管缝合术。

Objective To analyze retrospectively the application of Perclose Proglide vascular closure devices in patients with marked distortion of iliac artery after coronary artery angiography （CAG）. Methods Eighty patients with marked distortion of iliac artery were selected from 3760 CAG cases from August 2005 to December 2007. Only when 0.038＂ extra-support wire（TERUMO：Radifocus Guide Wire M） and/or 23 cm long sheeth （ST-Jude Medical） was used,CAG achieved all success for 80 patients. Perclose Proglide vascular closure devices were used in 35 cases,and the other 45 cases received traditional manual compression. The hematoma,bleeding,aneurysm and infection rate were compared between the two groups. Results All patients who used Perclose Proglide vascular closure devices achieved success,with 2 cases of hematoma and 1 case of bleeding,without aneurysm and infection. The hematoma,bleeding and aneurysm in control group were 3,1 and 1 cases,respectively. There was no difference between two groups. Conclusion It is safe and effective to use Perclose Proglide vascular closure devices in patients with marked distortion of iliac artery after CAG.