经皮冠状动脉介入治疗后应用第三代PerClose血管缝合器的初步临床观察

目的:初步评价在经皮冠状动脉介入治疗(PCI)后,应用第三代PerClose经皮血管缝合器的安全性、有效性和临床应用价值.方法:2005年2月～4月间,我们行PCI拔除股动脉鞘后,共有54例使用血管缝合器和107例行人工压迫止血的患者.比较两种止血方法的即刻止血时间、下肢制动时间及并发症的发生率.结果:第三代PerClose缝合组成功率为92.6%(50/54);与压迫组相比,缝合组的即刻止血时间和下肢制动时间在冠状动脉造影术和经皮冠脉内球囊扩张术后均显著缩短(P＜0.05);血管并发症(假性动脉瘤、皮下血肿等)发生率与人工压迫组接近(P＞0.05).结论:PCI术后应用第三代PerClose血管缝合器安全、有效,并减少了患者术后的不适和痛苦,并发症发生率与压迫组无明显差别.

Principical clinical observation of the third generation PerClose percutaneous vascular closure devices after percutaneous coronary intervention

Objective:To principically evaluate the safety,efficacy and the clinical feasibility of the third genaration PerClose percutaneous vascular closure devices following percutaneous coronary intervention(PCI).Methods:Between February and April 2005,161 consecutive patients of our department were enrolled in this study.The PerClose device was placed for suture-mediated arterial closure after femoral arterial access in 54 patients.There were 107 patients treated with manual compression after pull out the femoral arterial sheath.The time of swift hemostasis time,inferior extremitas braking time and the incidence of vascular complication and mortality rate were compared between the two groups.Results:The suture-mediated closure devices was successfully placed on 50 of 54 attempts,the rate was 92.6%.The time of swift hemostasis and inferior extremitas braking following coronary angiography and percutaneous coronary intervention was apparently decreaced(P<0.05).The incidence in vascular complication(including pseudoaneurysm,ecchymoma etc.)between the two groups was similar(P>0.05).Conclusion:Application of the third generation PerClose percutaneous vascular suture-mediated arterial closure devices is safe and efficient following percutaneous coronary intervention,and definitely reduces the postoperative suffering and discomfort.The risk of access-site-related vascular complications was similar for PerClose compared with mechanical compression.