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JAMA：血管封堵器可缩短经股动脉冠脉造影患者出血时间

2014-11-20 高晓方 译 医学论坛网

血管封堵器股动脉冠脉造影患者
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德国一项研究表明，在接受经股动脉冠脉造影的患者中，血管封堵器(VCD)在穿刺部位血管并发症方面不劣于人工按压，并且可缩短止血时间。 此项多中心临床试验共纳入4524例经由股总动脉实施冠脉血管造影的患者，并在血管造影后以1:1:1比率随机给予血管内VCD、血管外VCD或人工按压止血。主要终点为随机化30天后穿刺部位相关性血管并发症，次要终点包括至止血时间、重复人工按压以及VCD失败。

德国一项研究表明，在接受经股动脉冠脉造影的患者中，血管封堵器(VCD)在穿刺部位血管并发症方面不劣于人工按压，并且可缩短止血时间。

此项多中心临床试验共纳入4524例经由股总动脉实施冠脉血管造影的患者，并在血管造影后以1:1:1比率随机给予血管内VCD、血管外VCD或人工按压止血。主要终点为随机化30天后穿刺部位相关性血管并发症，次要终点包括至止血时间、重复人工按压以及VCD失败。

结果显示，血管内VCD、血管外VCD或人工按压组分别纳入1509、1506和1509例患者。出院前94%的患者接受穿刺部位复式超声检查。VCD和人工按压组分别有6.9%和7.9%出现主要终点(非劣性P<0.001)。VCD组患者的至止血时间显著短于人工按压组(1对10分钟，P<0.001)。血管内VCD组患者的至止血时间显著短于血管外VCD组(0.5对2.0分钟，P<0.001)，并且封堵装置故障率亦显著低于后者。

原始出处：

Schulz-Schüpke S1, Helde S2, Gewalt S2, Ibrahim T3, Linhardt M2, Haas K2, Hoppe K4, Böttiger C4, Groha P2, Bradaric C3, Schmidt R5, Bott-Flügel L6, Ott I2, Goedel J2, Byrne RA2, Schneider S3, Burgdorf C2, Morath T2, Kufner S2, Joner M7, Cassese S2, Hoppmann P3, Hengstenberg C1, Pache J4, Fusaro M2, Massberg S8, Mehilli J8, Schunkert H1, Laugwitz KL9, Kastrati A1; Instrumental Sealing of Arterial Puncture Site—CLOSURE Device vs Manual Compression (ISAR-CLOSURE) Trial Investigators.Comparison of Vascular Closure Devices vs Manual Compression After Femoral Artery Puncture: The ISAR-CLOSURE Randomized Clinical Trial.JAMA. 2014 Nov 19;312(19):1981-7. doi: 10.1001/jama.2014.15305.


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    2015-09-18 qingting

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    2015-06-03 d830382

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    2014-11-22 李研东

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    2014-11-22 sodoo

    #造影#

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