Vascular Closure Devices versus Manual Compression in Cardiac Interventional Procedures: Systematic Review and Meta-Analysis.
Vascular Closure Devices versus Manual Compression in Cardiac Interventional Procedures: Systematic Review and Meta-Analysis.
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DOI：
10.1155/2022/8569188
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发表时间：
2022
影响因子：
3.1
通讯作者：
Wang, Rui
中科院分区：
文献类型：
--
作者：
Pang, Naidong;Gao, Jia;Zhang, Binghang;Guo, Min;Zhang, Nan;Sun, Meng;Wang, Rui
人工加压（MC）和血管闭合装置（VCD）是心脏介入手术后血管通路止血的两种方法。然而，对其使用仍存在争议，缺乏全面、系统的meta分析。在PubMed、EMbase、Cochrane Library和Web of Science中检索到2022年4月之前比较VCD和MC在心脏介入手术中的原创文章。对两组的疗效、安全性、患者满意度等参数进行评估。研究间异质性分别采用I2指数和Cochran Q检验进行评价。采用漏斗图和Egger检验评估发表偏倚。通过纳入和排除标准筛选后，共纳入32项研究（33481例患者）。该荟萃分析发现，VCD可缩短止血、活动和出院时间（p < 0.00001）。在血管并发症风险方面，VCD组可能与较低的主要并发症风险相关（p = 0.0001），但仅限于随机对照试验的分析不支持这一结果（p = 0.68）。两组总并发症发生率（p = 0.08）和出血相关并发症发生率（p = 0.05）比较，差异均无统计学意义。VCD组患者满意度较高（p = 0.002）。meta回归分析显示上述结果无特定协变量作为影响因素（p < 0.05）。与MC相比，vcd的使用明显缩短了止血时间，可以更早地下床和出院，同时没有增加血管并发症。此外，使用vcd可以获得更高的患者满意度，并为患者和机构节省成本。
Manual compression (MC) and vascular closure device (VCD) are two methods of vascular access site hemostasis after cardiac interventional procedures. However, there is still controversial over the use of them and a lack of comprehensive and systematic meta-analysis on this issue. Original articles comparing VCD and MC in cardiac interventional procedures were searched in PubMed, EMbase, Cochrane Library, and Web of Science through April 2022. Efficacy, safety, patient satisfaction, and other parameters were assessed between two groups. Heterogeneity among studies was evaluated by I2 index and the Cochran Q test, respectively. Publication bias was assessed using the funnel plot and Egger's test. A total of 32 studies were included after screening with inclusion and exclusion criteria (33481 patients). This meta-analysis found that VCD resulted in shorter time to hemostasis, ambulation, and discharge (p < 0.00001). In terms of vascular complication risks, VCD group might be associated with a lower risk of major complications (p = 0.0001), but the analysis limited to randomized controlled trials did not support this result (p = 0.68). There was no significant difference in total complication rates (p = 0.08) and bleeding-related complication rates (p = 0.05) between the two groups. Patient satisfaction was higher in VCD group (p = 0.002). Meta-regression analysis revealed no specific covariate as an influencing factor for above results (p > 0.05). Compared with MC, the use of VCDs significantly shortens the time of hemostasis and allows earlier ambulation and discharge, meanwhile without increase in vascular complications. In addition, use of VCDs achieves higher patient satisfaction and leads cost savings for patients and institutions.
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影响因子：
1.7
作者：
Ben-Dor, Itsik;Craig, Paige;Waksman, Ron
通讯作者：
Waksman, Ron
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
DOI：
10.1177/1531003512442091
发表时间：
2012-03-01
期刊：
Perspectives in vascular surgery and endovascular therapy
影响因子：
--
作者：
Lupi, Alessandro;Rognoni, Andrea;Di Mario, Carlo
通讯作者：
Di Mario, Carlo
影响因子：
2.3
作者：
Ben-dor, Itsik;Looser, Patrick;Waksman, Ron
通讯作者：
Waksman, Ron
影响因子：
2.3
作者：
Burke, M. Nicholas;Hermiller, James;Jaff, Michael R.
通讯作者：
Jaff, Michael R.