Comparison of Femoral Artery Intervention Location After Coronary Angiography Using Sand Bag and Closure Device
Öz
Abstract
Background: Coronary angiography and percutaneous procedures to be performed with coronary artery bypass grafting are usually performed via the femoral artery because of the high success rate. In this study, it was planned to evaluate the effectiveness of the femoral arterial pneumatic compression device in coronary angiography and percutaneous coronary intervention.
Materials and Methods: Between January 2016 and August 2016, a total of 126 patients (66 male, 60 female) underwent coronary angiography in the cardiology clinic were included in the study. Femoral arterial pneumatic compression device (Close pad) was applied to 55 of the patients after the procedure. The femoral intervention site of the patients was visualized immediately after removal of the sheath and 24 hours after the procedure, visually local bruisingarea, hematoma, pseudoaneurysm and arteriovenous fistula early femoral complications were evaluated. Doppler ultrasound images of the femoral region were obtained from the patients deemed necessary. Patients using sandbags were compared with patients who applied closepad.
Findings: In our study, eczema was observed at similar frequency in the sand bag group and the close pad group. In the 14 patients who were placed in the sandwich bag with the octopause frequency, they were observed in 12 patients who applied closepad but the difference was not statistically significant (p = 0.348). The developing hematoma frequency was also similar. Hematomas were detectedin 3 patients using sandbags while hematomas were detected in 2 patients using closepad. In our study, femoral artery pseudoaneurysm was not observed in either group.
Conclusion:Compression of the femoral artery punc-ture site with the Close Pad in coronary interventions via femoral artery is a preferred method when compared with conventional hand-held sand bags. Pseudoaneurysms, ecchymoses and hematomas have been found to have similar safety and efficacy to the sand bags in terms of complications of the femoral region.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.Merriweather N, Sulzbach-Hoke LM. Managing risk of com-plications at femoral vascular accesssites in percutaneous co-ronary intervention. Crit Care Nurse 2012;32:16-29. 2.Choussat R, Black A, Bossi I, Fajadet J, Marco J. Vascularcomplication sand clinical out come after coronary angioplastywith platelet IIb/III a receptor blockade. Comparison of tran-sradial vs transfemoral arterial access. EurHeart J2000;21:662-7. 3.Shoulders-Odom B. Management of patient safter percutaneo-us coronary interventions. Crit Care Nurse 2008;28:26-42. 4.Aksoy M, Becquemin JP, Desgranges P, Allaire E, KobeiterH. The safety andefficacy of Angioseal in therapeutic endo-vascular interventions. Eur JEndovascSurg 2006; 32:90-3. 5.Geyik S, Yavuz K, Akgoz A, et al. The safety andefficacy ofthe Angio-Seal closure device in diagnostic and interventio-nal neuroangiography setting: a single-center experience with1,443 closures. Neuroradiology 2007; 49:739-46. 6.Abando A, Hood D, Weaver F, Katz S. Theuse of the Angio-seal device for femoral artery closure. J VascSurg 2004;40(2):287-90. 7.Reekers et al. CIRSE Vascular Closure Device Registry. Car-diovasc Intervent Radiol 2011; 34:50-3 8.Ratnam LA, Raja J, Munneke GJ, Morgan RA, Belli AM. Pros-pective non randomized trial of manual compression and An-gio-Seal and Star close arterial closure devices in common fe-moral punctures Cardiovasc Intervent Radiol 2007; 30:182-8. 9.Khaghany K, Al-Ali F, Spigelmoyer T, et al. Efficacy and sa-fety of the Perclose Closer S device after neurointerventionalprocedures: prospective study and literature review. AJNR AmJ Neuroradiol 2005; 26:1420-4. 10.Roberts A, Collins J, Harlamert E, Champion J, Cronin K, Av-ram J, et al. Safeguard Manual Assist Technique: The SMATStudy. CathLab Digest. http://bit.ly/17eh218. 11.Sanborn TA, Ogilby JD, Ritter JM, Stone GW, Klugherz BD,Fields RH, et al. Reduced vascular complications after per-cutaneous coronary interventions with a nonmechanical su-ture device: results from the randomized RACE study. Cathe-ter CardiovascInterv 2004;61:327-32. 12.Looby S, Keeling AN, McErlean A et al. Efficacy and safetyof anjioseal vascular closure device post antegrade punctu-re. Cardiovasc Intervent Radiol 2008; 31:558-68. 13.Koreny M, Riedmüller E, Nikfardjam M, Siostrzonek P, Müllner M. Arterial puncture closing devices compared with Stan-dard manual compression after cardiac catheterization: syste-matic review and meta-analysis. JAMA 2004; 291:350-7 14.Babu SC, Piccorelli GO, Shah PM, Stein JH, Clauss RH. In-cidence and results of arterial complications among 16,350patients undergoing cardiac catheterization. J VascSurg1989;10:113-6. 15.Hessel SJ, Adams DF, Abrams HL. Complications of angiog-raphy. Radiology 1981;138:273-81. 16.Bourassa MG, Noble J. Complication rate of coronary arte-riography. A review of 5250 cases studied by a percutaneo-us femoral technique. Circulation 1976;53:106-14 17.Seidenberg B, Hurwitt ES. Retrograde femoral (Seldinger) aor-tography: surgical complications in 26 cases. AnnSurg1966;163:221-6. 18.Choussat R, Black A, Bossi I, Fajadet J, Marco J. Vascularcomplications and clinical outcome after coronary angioplastywith plateletIIb/IIIa receptor blockade. Comparison of tran-sradial vs transfemoral arterial access. EurHeart J2000;21:662-7. 19.Philippe F, Larrazet F, Meziane T, Dibie A. Comparison oftransradial vs. transfemoral approach in the treatment of acu-te myocardial infarction with primary angioplasty and abci-ximab. Catheter Cardiovasc Interv 2004;61:67-73. 20.Kandzari DE, Tcheng JE, Cohen DJ, Bakhai A, Grines CL,Cox DA, et al. Feasibility and implications of an early disc-harge strategy after percutaneous intervention with abciximabin acute myocardial infarction (the CADILLAC Trial). Am JCardiol 2003;92:779-84
Femoral Arter Yoluyla Yapılan Koroner Anjiyografi Sonrası Girişim Yerinin Geleneksel Kum Torbası ve Kapama Cihazı Kullanılarak Kapatılmasının Karşılaştırılması
Öz
Öz
Amaç: Koroner artere uygulanılacak koroner anjiografi ve perkütan işlemler kolay erişilebilir olması ek olarak başarı oranının yüksek olması nedeniyle genellikle femoral arter yoluyla yapılmaktadır. Bu çalışmada koroner anjıografi ve perkütan koroner girişim işlemlerinde femoral arter pnömotik kompresyon cihazının etkinliğinin değerlendirilmesi amacıyla planlanmıştır.
Materiyel Metod: Ocak 2016 ile Ağustos 2016 tarihleri arasında Kardiyoloji kliniğinde koroner anjiografi yapılan 66 erkek 60 kadın toplam 126 hasta çalışmaya dahil edildi. Hastaların 55 ine işlem sonrası arteryel giriş yerinefemoral arter pnömotik kompresyon cihazı (Close pad) uygulandı. Hastaların femoral girişim yeri lokal damarsal komplikasyonlar açısından kılıfın çıkarılışından hemen sonra ve işlem sonrası 24. saatte hastaların, görsel olarak yerel morluk alanı, hematom, psödoanevrizma ve arteriyovenöz fistül gibi erken dönem femoral bölge komplikasyonları değerlendirildi. Gerekli görülenhastalardan femoral bölge Doppler ultrason görüntüleri alındı. Kum torbası kullanılan hastalarla closepad uygulanan hastalar karşılaştırıldı.
Bulgular:Çalışmamızda kum torbası konulan grup ile closepad uygulanan hastalarda benzer sıklıkta ekimoz gözlendi. Ekimoz sıklığı kum torbası konan 14 hastada gözlenirken closepad uygulanan 12 hastada gözlendi ancak aradaki fark istatistiksel olarak anlamlı değildi (p=0.348). Gelişen hematom sıklığı da yine benzerdi. Kum torbası kullanılan 3 hastada hematom görülürken closepad uygulanan 2 hastada hematom saptandı. Çalışmamızda femoral arter psödoanevrizması her iki grupta da hiç gözlenmedi.
Sonuç: Femoral arter yoluyla yapılan koroner girişimlerde femoral arter ponksiyonyerinin Close pad ile kompresyon yoluyla kapatılması klasik elle bası sonrası kum torbalarıyla kıyaslandığında tercih edilebilir bir yöntemdir. Psödoanevrizma, ekimoz ve hematom gibi femoral bölge komplikasyonları bakımından kum torbalarına benzer güvenlik ve etkinlikte olduğu saptanmıştır.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.Merriweather N, Sulzbach-Hoke LM. Managing risk of com-plications at femoral vascular accesssites in percutaneous co-ronary intervention. Crit Care Nurse 2012;32:16-29. 2.Choussat R, Black A, Bossi I, Fajadet J, Marco J. Vascularcomplication sand clinical out come after coronary angioplastywith platelet IIb/III a receptor blockade. Comparison of tran-sradial vs transfemoral arterial access. EurHeart J2000;21:662-7. 3.Shoulders-Odom B. Management of patient safter percutaneo-us coronary interventions. Crit Care Nurse 2008;28:26-42. 4.Aksoy M, Becquemin JP, Desgranges P, Allaire E, KobeiterH. The safety andefficacy of Angioseal in therapeutic endo-vascular interventions. Eur JEndovascSurg 2006; 32:90-3. 5.Geyik S, Yavuz K, Akgoz A, et al. The safety andefficacy ofthe Angio-Seal closure device in diagnostic and interventio-nal neuroangiography setting: a single-center experience with1,443 closures. Neuroradiology 2007; 49:739-46. 6.Abando A, Hood D, Weaver F, Katz S. Theuse of the Angio-seal device for femoral artery closure. J VascSurg 2004;40(2):287-90. 7.Reekers et al. CIRSE Vascular Closure Device Registry. Car-diovasc Intervent Radiol 2011; 34:50-3 8.Ratnam LA, Raja J, Munneke GJ, Morgan RA, Belli AM. Pros-pective non randomized trial of manual compression and An-gio-Seal and Star close arterial closure devices in common fe-moral punctures Cardiovasc Intervent Radiol 2007; 30:182-8. 9.Khaghany K, Al-Ali F, Spigelmoyer T, et al. Efficacy and sa-fety of the Perclose Closer S device after neurointerventionalprocedures: prospective study and literature review. AJNR AmJ Neuroradiol 2005; 26:1420-4. 10.Roberts A, Collins J, Harlamert E, Champion J, Cronin K, Av-ram J, et al. Safeguard Manual Assist Technique: The SMATStudy. CathLab Digest. http://bit.ly/17eh218. 11.Sanborn TA, Ogilby JD, Ritter JM, Stone GW, Klugherz BD,Fields RH, et al. Reduced vascular complications after per-cutaneous coronary interventions with a nonmechanical su-ture device: results from the randomized RACE study. Cathe-ter CardiovascInterv 2004;61:327-32. 12.Looby S, Keeling AN, McErlean A et al. Efficacy and safetyof anjioseal vascular closure device post antegrade punctu-re. Cardiovasc Intervent Radiol 2008; 31:558-68. 13.Koreny M, Riedmüller E, Nikfardjam M, Siostrzonek P, Müllner M. Arterial puncture closing devices compared with Stan-dard manual compression after cardiac catheterization: syste-matic review and meta-analysis. JAMA 2004; 291:350-7 14.Babu SC, Piccorelli GO, Shah PM, Stein JH, Clauss RH. In-cidence and results of arterial complications among 16,350patients undergoing cardiac catheterization. J VascSurg1989;10:113-6. 15.Hessel SJ, Adams DF, Abrams HL. Complications of angiog-raphy. Radiology 1981;138:273-81. 16.Bourassa MG, Noble J. Complication rate of coronary arte-riography. A review of 5250 cases studied by a percutaneo-us femoral technique. Circulation 1976;53:106-14 17.Seidenberg B, Hurwitt ES. Retrograde femoral (Seldinger) aor-tography: surgical complications in 26 cases. AnnSurg1966;163:221-6. 18.Choussat R, Black A, Bossi I, Fajadet J, Marco J. Vascularcomplications and clinical outcome after coronary angioplastywith plateletIIb/IIIa receptor blockade. Comparison of tran-sradial vs transfemoral arterial access. EurHeart J2000;21:662-7. 19.Philippe F, Larrazet F, Meziane T, Dibie A. Comparison oftransradial vs. transfemoral approach in the treatment of acu-te myocardial infarction with primary angioplasty and abci-ximab. Catheter Cardiovasc Interv 2004;61:67-73. 20.Kandzari DE, Tcheng JE, Cohen DJ, Bakhai A, Grines CL,Cox DA, et al. Feasibility and implications of an early disc-harge strategy after percutaneous intervention with abciximabin acute myocardial infarction (the CADILLAC Trial). Am JCardiol 2003;92:779-84
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Eylül 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 9 Sayı: 5 |
