Safety and efficacy of the Perclose suture-mediated closure device following carotid artery stenting under clopidogrel platelet blockade
Safety and efficacy of the Perclose suture-mediated closure device following carotid artery stenting under clopidogrel platelet blockade
复制标题
氯吡格雷血小板阻断下颈动脉支架置入术后 Perclose 缝合介导的闭合装置的安全性和有效性
DOI：
10.1007/s00330-003-2143-x
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发表时间：
2004
影响因子：
5.9
通讯作者：
J. Link
中科院分区：
文献类型：
--
作者：
N. Zorger;T. Finkenzeller;M. Lenhart;O. Hamer;C. Paetzel;I. Borisch;I. Toepel;S. Feuerbach;J. Link
本研究的目的是评估一种闭合装置（Perclose，Menlo Park，CA），用于颈动脉支架置入术后接受积极抗凝和血小板阻断的患者股动脉通路部位的闭合。 55 名患者除阿司匹林和肝素外还接受氯吡格雷作为颈动脉支架置入术药物，在使用 7-或 8-F 引导导管后缝合股骨通路部位。对技术成功、缝合时间、凝血参数和并发症进行了检查。进行了后续调查，包括超声波和临床检查。检查腹股沟是否有可能的血肿、假性动脉瘤、动静脉瘘和局部感染。 54 名患者中有 51 名 (94%) 在平均手术时间为 6 分钟（范围 5-10 分钟）后获得了技术成功。一名患者 (2%) 由于解剖原因未使用缝合装置，54 名患者中有 3 名 (6%) 未能止血。 54 名患者中有 4 名 (7%) 在干预后 4-6 小时在穿刺部位观察到出血，并使用加压绷带进行治疗。干预前平均专用激活凝血时间为 137 秒（范围 29-287 秒），部署 Perclose 设备前为 349 秒（150-958 秒）。在 2 天（范围 2-6 天）和 6 个月后的随访中，除了两个大的腹股沟血肿外，没有观察到穿刺部位出现其他并发症。没有发生重大并发症。即使对于接受积极抗凝和抗血小板治疗的患者，使用 Perclose 闭合装置进行颈动脉支架置入术后股动脉通路部位的闭合也是安全有效的。
The aim of this study was evaluation of a closure device (Perclose, Menlo Park, Calif.) for closure of the femoral artery access site in patients undergoing aggressive anticoagulation and platelet blockade after carotid stenting. Fifty-five patients who received clopidogrel in addition to aspirin and heparin as medication for carotid stenting were included for suture of the femoral access site after using 7- or 8-F guide catheters. The technical success, the time for suture, the clotting parameters, and complications were examined. Follow-up investigations, including ultrasound and clinical examinations, were performed. The groin was checked for possible hematoma, pseudoaneurysm, arteriovenous fistula, and local infection. Technical success was obtained in 51 of 54 patients (94%) after a mean procedure time of 6 min (range 5–10 min). The suture device was not used in one patient (2%) for anatomical reasons and failed to obtain hemostasis in 3 of 54 (6%) patients. In 4 of 54 patients (7%) bleeding was observed at the punctured site 4–6 h after intervention which was treated by a compression bandage. The mean dedicated activated clotting time was 137 s (range 29–287 s) before intervention and 349 s (150–958 s) just before deploying the Perclose device. During follow-up after 2 days (range 2–6 days) and 6 months no further complications of the puncture site were observed except for two large groin hematomas. No major complications occurred. Closure of the femoral access site after carotid stenting using a Perclose closure device is safe and effective even in patients receiving an aggressive anticoagulation and antiplatelet therapy.
接受糖蛋白 IIb-IIIa 抑制剂的患者经皮冠状动脉介入治疗后的血管闭合装置和血管并发症的风险。
DOI：
10.1016/s0002-9149(01)01725-8
发表时间：
2001
期刊：
The American journal of cardiology
影响因子：
--
作者：
Resnic,FS;Blake,GJ;Ohno-Machado,L;Selwyn,AP;Popma,JJ;Rogers,C
通讯作者：
Rogers,C