血管闭合器简介
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摘要
血管闭合器是经皮血管穿刺后用于穿刺点止血的医疗器械,根据其原理大致可分为主动血管闭合器、压迫辅助闭合器及表面止血贴。它们可缩短介入治疗术后止血时间、制动时间及住院时间,减少患者创伤,提高患者舒适度,同时亦减轻医护人员工作负担。但每款闭合器均有其适用范围及学习曲线等,应用不当可能导致严重并发症,因此介入医师在采用闭合器前应熟知其特点并掌握常见并发症处理。本文综合闭合器厂家资料及近年相关研究文献,就数款常见血管闭合器原理、特点、适用范围及使用技巧等作一简单介绍。
A vascular closure device(VCD) is a medical apparatus which is used for stopping bleeding at the puncture point after percutaneous vascular puncturing management. According to its principles, these devices can be categorized into active closure device, compression-assisted device and local hemostatic plaster. The use of these devices can shorten the time of hemostasis, the time of limb immobilization, and the time of hospitalization; it can also reduce the damage to the patient, improve patient's comfort, and reduce the work load of the medical staff as well. But each VCD has its own applicable scope and learning curve,thus it might cause serious complications when it is improperly used. Therefore, in using VCD the interventional physicians should be familiar with the characteristics of each special VCD and have enough knowledge concerning the treatment of the common complications. This paper aims to make a comprehensive review of the closure device manufacturer data and the relevant literatures recently published so as to make a brief introduction of the principle, characteristics, scope of application and practical tips of several common vascular closure devices.
A vascular closure device(VCD) is a medical apparatus which is used for stopping bleeding at the puncture point after percutaneous vascular puncturing management. According to its principles, these devices can be categorized into active closure device, compression-assisted device and local hemostatic plaster. The use of these devices can shorten the time of hemostasis, the time of limb immobilization, and the time of hospitalization; it can also reduce the damage to the patient, improve patient's comfort, and reduce the work load of the medical staff as well. But each VCD has its own applicable scope and learning curve,thus it might cause serious complications when it is improperly used. Therefore, in using VCD the interventional physicians should be familiar with the characteristics of each special VCD and have enough knowledge concerning the treatment of the common complications. This paper aims to make a comprehensive review of the closure device manufacturer data and the relevant literatures recently published so as to make a brief introduction of the principle, characteristics, scope of application and practical tips of several common vascular closure devices.
引文
[1]Hon LQ,Ganeshan A,Thomas SM,et al.An overview of vascular closure devices:What every radiologist should know[J].Eur J Radiol,2010,73:181-190.
[2]Sheth RA,Walker TG,Saad WE,et al.Quality improvement guidelines for vascular access and closure device use[J].J Vasc Interv Radiol,2014,25:73-84.
[3]St Jude Medical.Angio-Seal vascular closure device instructions for use[EB/OL].http://professional.sjm.com/resources/ifu/vas/hemostasis-management/vascular-closure,2011.
[4]Bui QT,Kolansky DM,Bannan A,et al.“Double wire”angio-seal closure technique after balloon aortic valvuloplasty[J].Catheter Cardiovasc Interv,2010,75:488-492.
[5]Cordis Corporation.Exo Seal vascular closure device instructions for use[EB/OL].http://www.cordislabeling.com/pdf/12276406.pdf,2012.
[6]Access Closure Inc.Mynx vascular closure device instructions for use[EB/OL].http://www.accessclosure.com/wp-content/uploads/2013/10/Mynx_Ace_IFU.pdf,2014.
[7]Cardiva Medical Inc.Vascade vascular closure system instructions for use[EB/OL].http://www.cardivamedical.com/site/assets/files/1052/vascade-ifu.pdf,2013.
[8]Abbott Vascular Inc.Prostar XL percutaneous vascular surgical system instructions for use[EB/OL].http://www.abbottvascular.com/docs/ifu/vessel_closure/e IFU_Prostar XL10F.pdf,2012.
[9]Abbott Vascular Inc.Perclose Pro Glidesuture-mediated closure system instructions for use[EB/OL].http://www.abbottvascular.com/docs/ifu/vessel_closure/e IFU_Perclose_Pro Glide.pdf,2013.
[10]Haulon S,Hassen Khodja R,Proudfoot CW,et al.A systematic literature review of the efficacy and safety of the Prostar XL device for the closure of large femoral arterial access sites in patients undergoing percutaneous endovascular aortic procedures[J].Eur J Vasc Endovasc Surg,2011,41:201-213.
[11]Skagius E,Bosnjak M,Bj觟rck M,et al.Percutaneous closure of large femoral artery access with Prostar XL in thoracic endovascular aortic repair[J].Eur J Vasc Endovasc Surg,2013,46:558-563.
[12]张宏鹏,郭伟,刘小平,等.完全穿刺技术在腹主动脉瘤腔内修复术中的应用[J].中华外科杂志,2010,48:1855-1858.
[13]Abbott Vascular Inc.Star Closevascular closure system instructions for use[EB/OL].http://www.abbottvascular.com/docs/ifu/vessel_closure/e IFU_Starclose SE.pdf,2012.
[14]Schwartz BG,Burstein S,Economides CA,et al.Review of vascular closure devices[J].J Invasive Cardiol,2010,22:599-607.
[15]林兆恒.血管闭合装置在心血管介入治疗后股动脉止血中的应用:安全性、有效性及并发症发生率[J].中国组织工程研究与临床康复,2010,14:710-713.
[16]St Jude Medical Systems AB.Femo Stop femoral compression systemin structionsfor use[EB/OL].http://professional.sjm.com/resources/ifu/vas/hemostasis-management/com pression-assist,2012.
[17]Cardiva Medical Inc.Catalyst system instructions for use[EB/OL].http://www.cardivamedical.com/site/assets/files/1063/ifu_2218_rev_n_instructions_for_use_for_catalyst_ii.pdf,2013.
[18]Scion Cardiovascular.Clo-Sur P.A.D.instructions for use[EB/OL].http://scionbiomed.com/wp/wp-content/uploads/2014/06/00839-Rev-B-Clo-Sur-PAD-IFU-Graphics.pdf,2012.
[19]曾庆福,张学民,张小明,等.穿刺缝合技术在主动脉疾病腔内介入治疗中的应用[J].中华普通外科杂志,2012,27:903-906.
[2]Sheth RA,Walker TG,Saad WE,et al.Quality improvement guidelines for vascular access and closure device use[J].J Vasc Interv Radiol,2014,25:73-84.
[3]St Jude Medical.Angio-Seal vascular closure device instructions for use[EB/OL].http://professional.sjm.com/resources/ifu/vas/hemostasis-management/vascular-closure,2011.
[4]Bui QT,Kolansky DM,Bannan A,et al.“Double wire”angio-seal closure technique after balloon aortic valvuloplasty[J].Catheter Cardiovasc Interv,2010,75:488-492.
[5]Cordis Corporation.Exo Seal vascular closure device instructions for use[EB/OL].http://www.cordislabeling.com/pdf/12276406.pdf,2012.
[6]Access Closure Inc.Mynx vascular closure device instructions for use[EB/OL].http://www.accessclosure.com/wp-content/uploads/2013/10/Mynx_Ace_IFU.pdf,2014.
[7]Cardiva Medical Inc.Vascade vascular closure system instructions for use[EB/OL].http://www.cardivamedical.com/site/assets/files/1052/vascade-ifu.pdf,2013.
[8]Abbott Vascular Inc.Prostar XL percutaneous vascular surgical system instructions for use[EB/OL].http://www.abbottvascular.com/docs/ifu/vessel_closure/e IFU_Prostar XL10F.pdf,2012.
[9]Abbott Vascular Inc.Perclose Pro Glidesuture-mediated closure system instructions for use[EB/OL].http://www.abbottvascular.com/docs/ifu/vessel_closure/e IFU_Perclose_Pro Glide.pdf,2013.
[10]Haulon S,Hassen Khodja R,Proudfoot CW,et al.A systematic literature review of the efficacy and safety of the Prostar XL device for the closure of large femoral arterial access sites in patients undergoing percutaneous endovascular aortic procedures[J].Eur J Vasc Endovasc Surg,2011,41:201-213.
[11]Skagius E,Bosnjak M,Bj觟rck M,et al.Percutaneous closure of large femoral artery access with Prostar XL in thoracic endovascular aortic repair[J].Eur J Vasc Endovasc Surg,2013,46:558-563.
[12]张宏鹏,郭伟,刘小平,等.完全穿刺技术在腹主动脉瘤腔内修复术中的应用[J].中华外科杂志,2010,48:1855-1858.
[13]Abbott Vascular Inc.Star Closevascular closure system instructions for use[EB/OL].http://www.abbottvascular.com/docs/ifu/vessel_closure/e IFU_Starclose SE.pdf,2012.
[14]Schwartz BG,Burstein S,Economides CA,et al.Review of vascular closure devices[J].J Invasive Cardiol,2010,22:599-607.
[15]林兆恒.血管闭合装置在心血管介入治疗后股动脉止血中的应用:安全性、有效性及并发症发生率[J].中国组织工程研究与临床康复,2010,14:710-713.
[16]St Jude Medical Systems AB.Femo Stop femoral compression systemin structionsfor use[EB/OL].http://professional.sjm.com/resources/ifu/vas/hemostasis-management/com pression-assist,2012.
[17]Cardiva Medical Inc.Catalyst system instructions for use[EB/OL].http://www.cardivamedical.com/site/assets/files/1063/ifu_2218_rev_n_instructions_for_use_for_catalyst_ii.pdf,2013.
[18]Scion Cardiovascular.Clo-Sur P.A.D.instructions for use[EB/OL].http://scionbiomed.com/wp/wp-content/uploads/2014/06/00839-Rev-B-Clo-Sur-PAD-IFU-Graphics.pdf,2012.
[19]曾庆福,张学民,张小明,等.穿刺缝合技术在主动脉疾病腔内介入治疗中的应用[J].中华普通外科杂志,2012,27:903-906.