Feasibility and safety of total percutaneous closure of femoral arterial access sites after veno-arterial extracorporeal membrane oxygenation
Feasibility and safety of total percutaneous closure of femoral arterial access sites after veno-arterial extracorporeal membrane oxygenation
复制标题
静脉-动脉体外膜肺氧合后经皮完全封闭股动脉通路的可行性和安全性
DOI：
10.1097/md.0000000000017910
复制
发表时间：
2019-11-01
期刊：
影响因子：
1.6
通讯作者：
Huang, Man
中科院分区：
文献类型：
--
作者：
Xu, Xin;Liu, Zhenjie;Huang, Man
摘要评价使用Perclose ProGlide器械在静脉-动脉体外膜肺氧合（VA-ECMO）后完全经皮闭合股动脉穿刺部位的安全性和有效性。这项近2年的回顾性观察性研究纳入了21例接受VA-ECMO的患者，其中股动脉穿刺部位使用Perclose ProGlide器械进行了封堵。技术成功定义为成功闭合股总动脉，无需额外的外科手术或血管内手术。在动脉闭合后24小时和30天记录穿刺部位并发症，如需要输血或手术干预的大出血、轻微出血、腹股沟感染、假性动脉瘤和淋巴囊肿。20例患者（95.2%）实现了技术成功。1例患者因穿刺部位假性动脉瘤需要手术修复。18例股动脉分别用2件器械闭合，而3例患者需要使用第三件器械闭合股动脉穿刺部位以实现充分止血。围手术期（动脉闭合后24小时内）或30天随访期间未发生动脉血栓形成、动脉夹层、动脉狭窄、腹股沟感染或动静脉瘘。使用Perclose ProGlide器械经皮闭合是VA-ECMO后闭合股动脉穿刺部位的可行手术，穿刺部位并发症的发生率较低。
Abstract To evaluate the safety and efficacy of total percutaneous closure of the femoral artery access site after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with the Perclose ProGlide device. This retrospective observational study during an almost 2-year period included 21 patients who underwent VA-ECMO in whom the femoral artery puncture site was closed percutaneously with Perclose ProGlide devices. Technical success was defined as successful arterial closure of the common femoral artery, without the need for additional surgical or endovascular procedures. Access site complications were recorded at 24 hours and 30 days after arterial closure, such as major bleeding requiring transfusion or surgical intervention, minor bleeding, groin infection, pseudoaneurysm, and lymphocele. Technical success was achieved in 20 patients (95.2%). One patient required surgical repair for an access site pseudoaneurysm. Eighteen femoral arteries were closed with 2 devices each, while 3 patients required the use of a third device for femoral artery access site closure to achieve adequate hemostasis. No arterial thrombosis, arterial dissection, arterial stenosis, groin infection, or arteriovenous fistula occurred during the periprocedural period (within 24 hours of arterial closure) or during 30-day follow-up. Percutaneous closure with the Perclose ProGlide device is a feasible procedure for closing femoral arterial access sites after VA-ECMO, with a low incidence of access site complications.