Hemostatic efficacy of chitosan-based bandage for closure of percutaneous arterial access sites: An experimental study in heparinized sheep model
Hemostatic efficacy of chitosan-based bandage for closure of percutaneous arterial access sites: An experimental study in heparinized sheep model
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DOI：
10.2478/v10019-010-0021-0
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发表时间：
2010-06-01
影响因子：
2.4
通讯作者：
Roesch, Josef
中科院分区：
文献类型：
--
作者：
Kranokpiraksa, Pawanrat;Pavcnik, Dusan;Roesch, Josef
背景。目前大多数经皮动脉封闭装置（PACD）用于介入血管手术后的止血是有效的，但有异物沉积并发症的风险。研究了一种具有广阔应用前景的外用PACD壳聚糖基HemCon绷带（HCB）。将HCB止血效果和并发症与标准手动按压（SMC）进行比较。材料和方法。9只肝素化羊的双股浅动脉（SFA）用8F护套插管5分钟。鞘拔出后，比较HCB和SMC对侧SFA的止血效果。经颈动脉入路行髂血管造影确定止血时间。HCB的平均止血时间为6.9 +/- 3.9分钟，而SMC的平均止血时间为10.8 +/- 2.8分钟（p值为0.019）。HCB组7例SFA在5分钟内止血，SMC组只有1例SFA在5分钟内止血。使用HCB的9例sfa均显示股动脉通畅，血肿（2/9）少于SMC组（8/9）。HCB组无并发症发生，SMC组出现1例SFA闭塞。肝素化羊外用HCB安全有效。它显著缩短了8F鞘切除后SFA通路处的止血时间。适当应用HCB对于缩短止血时间和防止血肿形成是必要的。HCB应在临床对照研究中进行测试，以评估其对人类的功效。
Background. Most of the presently used percutaneous arterial closure devices (PACD) for hemostasis after interventional vascular procedures are effective, but carry risk of complications by deposition of a foreign body. A new promising externally applied PACD - chitosan-based HemCon Bandage (HCB) was explored in sheep. The HCB hemostatic efficacy and complications occurring with its use were compared to those with the standard manual compression (SMC).Material and methods. Both superficial femoral arteries (SFA) of 9 heparinized sheep were catheterized with an 8F sheath for 5 minutes. After the sheath withdrawal, hemostasis with the HCB was compared with hemostasis achieved with SMC in the contralateral SFA. Iliac angiograms performed by carotid artery approach determined the hemostasis time.Results. The HCB use shortened time to hemostasis with a mean time of 6.9 +/- 3.9 minutes versus 10.8 +/- 2.8 minutes for the SMC (P-value 0.019). Seven SFAs in the HCB group and only 1 SFA in the SMC group exhibited hemostasis in 5 minutes. All nine SFAs using the HCB showed femoral artery patency and demonstrated less hematoma (2/9) than in the SMC group (8/9). No complications developed in the HCB group, one SFA occlusion was seen in the SMC group.Conclusions. The externally applied HCB in heparinized sheep was safe and effective. It significantly shortened time to hemostasis at the SFA access sites following 8F sheath removal. Proper application of the HCB was necessary to shorten hemostasis and prevent hematoma formation. The HCB should be tested in a clinically controlled study to evaluate its efficacy in humans.