ExoSeal血管封堵器在股总动脉顺行入路腔内治疗中的应用

Application of ExoSeal vascular closure device in interventional management via antegrade femoral access

目的探讨ExoSeal血管封堵器在股总动脉顺行入路行下肢动脉腔内再通术治疗中的安全性及临床应用价值。方法回顾性分析303例(316条患肢)接受顺行下肢动脉再通治疗患者的临床及影像资料,其中127例患者接受ExoSeal血管封堵器对股动脉穿刺点止血(血管封堵器组),176例患者接受传统压迫止血(手工压迫组)。记录并比较2组止血时间、实际制动时间、技术成功率及血管相关并发症。结果血管封堵器组与手工压迫组的止血时间分别为(3.68±2.40)min和(18.32±4.54)min,实际制动时间分别为(3.45±5.30)h和(10.44±14.68)h,技术成功率分别为98.52%(133/135)和93.92%(170/181),并发症发生率分别为2.22%(3/135)和8.84%(16/181),2组比较差异均有统计学意义(P均<0.05)。血管封堵器组发生皮下血肿2例,腹膜后血肿1例;手工压迫组发生皮下血肿15例,穿刺侧肢体急性血栓形成1例。结论采用ExoSeal血管封堵器在股动脉顺行腔内治疗中对股动脉穿刺点止血是一种安全、有效的方法。

Objective To investigate the safety and clinical value of using ExoSeal vascular closure device（VCD）in interventional management via antegrade femoral access.Methods Clinical and imaging data of 303 patients（316 affected limbs）who were received interventional procedure via antegrade femoral access closure were retrospectively analyzed.ExoSeal VCD（VCD group,n=127）and manual compression（MC group,n=176）were performed to make femoral artery puncture point hemostasis.The time of hemostasis,actual immobilization time,technical success rate and vascular related complications were recorded and compared between the two groups.Results In VCD group and MC group,the time of hemostasis were（3.68±2.40）min and（18.32±4.54）min,the actual immobilization time were（3.45±5.30）h and（10.44±14.68）h,the technical success rates were 98.52%（133/135）and 93.92%（170/181）,and the complication rates were 2.22%（3/135）and 8.84%（16/181）,respectively.There were statistically significant differences between two groups（all P〈0.05）.In VCD group,there were 2 cases of subcutaneous hematomas,and 1 case of retroperitoneal hematoma.In MC group,there were 15 cases of subcutaneous hematomas and 1 case of acute thrombosis in the puncture side limb.Conclusion Regarding hemostasis of puncture site in interventional management via antegrade femoral access,the use of ExoSeal VCD is safe and effective.