Vascular closure devices and the risk of vascular complications after percutaneous coronary intervention in patients receiving glycoprotein IIb-IIIa inhibitors.
Vascular closure devices and the risk of vascular complications after percutaneous coronary intervention in patients receiving glycoprotein IIb-IIIa inhibitors.
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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
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Rogers,C
中科院分区：
文献类型：
--
作者：
Resnic,FS;Blake,GJ;Ohno-Machado,L;Selwyn,AP;Popma,JJ;Rogers,C
与传统的经皮冠状动脉介入治疗 (PCI) 后止血方法相比，血管闭合装置在患者舒适度和下床活动时间方面具有优势。我们研究此类装置是否还能降低选定患者群体发生血管并发症的风险。我们对 1998 年 1 月至 1999 年 12 月期间在我们机构接受 PCI 的所有患者进行了回顾性分析。在 3,151 名连续患者中，3,027 名有资格接受血管闭合装置。其中，1,485 人接受了闭合装置，1,409 人接受了糖蛋白 IIb-IIIa 拮抗剂。总体血管并发症发生率为 4.20%，其定义为需要手术修复或输血，或发生动静脉瘘、假性动脉瘤或大血肿。通过单变量分析，封堵器的使用与较低的血管并发症发生率（3.03% vs 5.52%；p = 0.002）和较短的住院时间（2.77 vs 3.97 天，p <0.001）相关。多变量分析显示封堵器的血管并发症显着减少（比值比 0.59，p = 0.007）。对于接受糖蛋白 IIb-IIIa 拮抗剂的患者亚组，闭合装置的使用与血管并发症风险的显着降低相关（比值比 0.45，p <0.008）。因此，在特定接受 PCI 的患者中使用闭合装置可降低血管并发症发生率并缩短住院时间。对于接受糖蛋白 IIb-IIIa 拮抗剂的患者来说，这种益处最为明显。
Vascular closure devices offer advantages over traditional means of obtaining hemostasis after percutaneous coronary intervention (PCI) in terms of patient comfort and time to ambulation. We investigate whether such devices also reduce the risk of vascular complications in selected patient populations. We conducted a retrospective analysis of all patients who underwent PCI at our institution between January 1998 and December 1999. Of 3,151 consecutive patients, 3,027 were eligible to receive vascular closure devices. Of these, 1,485 received a closure device and 1,409 received glycoprotein IIb-IIIa antagonists. The overall vascular complication rate, as defined by the need for surgical repair or transfusion, or the development of arteriovenous fistula, pseudoaneurysm, or large hematoma, was 4.20%. By univariate analysis, the use of closure devices was associated with a lower vascular complication rate (3.03% vs 5.52%; p = 0.002) and a shorter length of hospital stay (2.77 vs 3.97 days, p <0.001). Multivariate analysis showed a significant reduction in vascular complications with closure devices (odds ratio 0.59, p = 0.007). For the subgroup of patients receiving glycoprotein IIb-IIIa antagonists, the use of closure devices was associated with an even more pronounced reduction in the risk of vascular complications (odds ratio 0.45, p <0.008). Thus, the use of closure devices in selected patients undergoing PCI is associated with a low rate of vascular complications and decreased length of stay. This benefit was most marked for patients receiving glycoprotein IIb-IIIa antagonists.