Rapid hemostasis at the femoral venous access site using a novel hemostatic pad containing kaolin after atrial fibrillation ablation
Rapid hemostasis at the femoral venous access site using a novel hemostatic pad containing kaolin after atrial fibrillation ablation
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DOI：
10.1007/s10840-011-9552-6
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发表时间：
2011-08-01
影响因子：
1.8
通讯作者：
Kihara, Yasuki
中科院分区：
文献类型：
--
作者：
Sairaku, Akinori;Nakano, Yukiko;Kihara, Yasuki
背景 由于积极抗凝和使用多个大尺寸鞘管，房颤 (AF) 消融后股静脉通路部位的止血时间往往会延长。新开发的止血垫含有一种叫做高岭土的天然矿物质，可以使血液迅速凝结。我们评估了该垫在 AF 消融后静脉通路部位的止血效果。 方法 计划接受 AF 消融的患者被随机分配接受手动加压治疗，使用高岭土浸渍垫 (n = 59) 或不使用高岭土浸渍垫 (n = 59) 作为股骨静脉通路部位拔除护套后的止血方法。比较两组之间的止血时间、再出血频率、大量血肿、装置相关并发症和深静脉血栓 (DVT)。 结果 使用高岭土浸渍垫治疗的患者的止血时间明显短于未治疗的患者（6.1 +/- 2.3 vs. 14.5 +/- 4.0 分钟；p < 0.0001）。多元线性回归分析显示，使用高岭土浸渍垫是减少止血时间的唯一自变量（β = -0.78；p < 0.0001）。然而，两组的再出血率相似（使用高岭土浸渍垫时为 37%，未使用高岭土浸渍垫时为 46%；p = 0.35）。仅 1 例患者出现巨大腹股沟血肿，无患者出现器械相关并发症或 DVT。结论 高岭土浸渍止血垫安全有效地缩短了 AF 消融患者股静脉通路部位的止血时间。然而，它的使用是否允许较早的术后行走很难预测。
Background Hemostasis at the femoral venous access site after atrial fibrillation (AF) ablation is often prolonged because of aggressive anticoagulation and the use of several large-sized sheaths. A newly developed hemostatic pad containing a natural mineral called kaolin causes blood to clot quickly. We evaluated the efficacy of this pad for hemostasis at the venous access site after AF ablation.Methods Patients who were scheduled to undergo AF ablation were randomized to be treated with manual compression with (n = 59) or without kaolin-impregnated pads (n = 59) as hemostatic approaches at the femoral venous access site following sheath removal. Hemostasis time, rebleeding frequency, massive hematoma, device-related complications, and deep venous thrombosis (DVT) were compared between the two groups.Results Hemostasis time in the patients treated with kaolin-impregnated pads was significantly shorter than in those treated without (6.1 +/- 2.3 vs. 14.5 +/- 4.0 min; p < 0.0001). Multiple linear regression analysis revealed that the use of kaolin-impregnated pads was the only independent variable reducing hemostasis time (beta = -0.78; p < 0.0001). However, rebleeding rates of the two groups were similar (37% with vs. 46% without kaolin-impregnated pads; p = 0.35). Only one patient had a massive groin hematoma, and no patient had device-related complications or DVT.Conclusions Kaolin-impregnated hemostatic pads safely and effectively decreased hemostasis time for the femoral venous access site in patients undergoing AF ablation. However, whether its use allows earlier postprocedural ambulation is difficult to predict.