دورية أكاديمية
Safety and efficacy of suture-mediated closure after percutaneous coronary interventions.
| العنوان: | Safety and efficacy of suture-mediated closure after percutaneous coronary interventions. |
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| المؤلفون: | Rinder MR; Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA., Tamirisa PK, Taniuchi M, Kurz HI, Mumm K, Lasala JM |
| المصدر: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2001 Oct; Vol. 54 (2), pp. 146-51. |
| نوع المنشور: | Clinical Trial; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Liss Country of Publication: United States NLM ID: 100884139 Publication Model: Print Cited Medium: Print ISSN: 1522-1946 (Print) Linking ISSN: 15221946 NLM ISO Abbreviation: Catheter Cardiovasc Interv Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Wiley-Liss, c1999- |
| مواضيع طبية MeSH: | Angioplasty, Balloon, Coronary*, Aneurysm, False/*etiology , Arteriovenous Fistula/*etiology , Coronary Disease/*therapy , Hematoma/*etiology , Hemorrhage/*etiology , Suture Techniques/*adverse effects , Suture Techniques/*instrumentation , Vascular Diseases/*etiology, Aged ; Aneurysm, False/surgery ; Arteriovenous Fistula/surgery ; Blood Transfusion ; Cohort Studies ; Early Ambulation ; Female ; Hematoma/surgery ; Hemorrhage/surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Vascular Diseases/surgery ; Vascular Surgical Procedures |
| مستخلص: | Percutaneous coronary interventions (PCI) performed with concomitant use of heparin and platelet inhibitors are safe procedures with reported vascular complication rates of approximately 6.1%. EPILOG investigators demonstrated that utilizing a low-dose heparin regimen with abciximab, along with early sheath removal, vascular access-related bleeding was significantly lower than that reported in EPIC. Recently, a suture-mediated closure (SMC) device has been reported to be safe, appears effective, and may improve patient comfort by allowing early ambulation. We conducted a retrospective analysis (January 1999 to March 2000) of complication frequencies among PCI patients who underwent SMC and those who had manual compression (non-SMC). Furthermore, we compared the overall rates of complications to patients who underwent PCI prior to the introduction of SMC (1995-1998). When comparing the current cohort to the historical cohort, there was a significant decrease in the number of retroperitoneal bleeds (0.3% vs. 0.9%; P = 0.003), hematomas (5% vs. 9%; P < 0.001), pseudoaneurysms (1.2% vs. 2.7%; P < 0.001), and need for vascular surgery (0.9% vs. 2.8%; P < 0.001). There was no difference in the number of arterio-venous fistulas and a slight increase in transfusion needs (12% vs. 10%; P = 0.03). Within the current cohort, there was no difference in the vascular complications between SMC and non-SMC PCI patients, although there were lower rates of pseudoaneurysms (0.5% vs. 1.8%; P = 0.02) and transfusion requirements (72/880 vs. 132/874; P < 0.001). These results suggest that the complication rates for SMC are not different and may be lower when compared to non-SMC patients after PCI. At our institution, the practice of early sheath removal and less aggressive heparin dosing has led to a decrease in vascular complication rates and a 66% reduction in vascular surgeries on post-PCI patients. Because of the limitations of retrospective analyses, further studies will be necessary to confirm these findings. (Copyright 2001 Wiley-Liss, Inc.) |
| تواريخ الأحداث: | Date Created: 20011009 Date Completed: 20011101 Latest Revision: 20191105 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1002/ccd.1256 |
| PMID: | 11590673 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1522-1946 |
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| DOI: | 10.1002/ccd.1256 |