| 徐俊杰.单把ProGlide血管缝合器建立体外膜肺氧合辅助下高危经皮冠状动脉介入治疗患者的安全性[J].内科急危重症杂志,2026,32(4):369-372 |
| 单把ProGlide血管缝合器建立体外膜肺氧合辅助下高危经皮冠状动脉介入治疗患者的安全性 |
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| DOI：10.11768/nkjwzzzz.202409190912 |
| 中文关键词: Proglide 血管缝合器 高危经皮冠状动脉介入治疗 动脉-静脉体外膜肺氧合 |
| 英文关键词: Proglide Vascular suture device high-risk percutaneous coronary intervention Venoarterial extracorporeal membrane oxygenation |
| 基金项目:湖北省武汉市科技局项目（2019020701011422）；武汉市心血管影像临床医学研究中心2023年度开放基金立项项目（CMRC202305） |
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| 中文摘要: |
| 摘要 目的：探讨单把ProGlide血管缝合器建立动脉-静脉体外膜肺氧合（VA-ECMO）管路与撤机处理路径血管的安全性。方法：回顾性分析预防性建立VA-ECMO管路辅助下行高危经皮冠状动脉介入（HR-PCI）治疗的189例患者的临床资料，均采用单把ProGlide血管缝合器预缝合技术处理股动脉穿刺点，评估VA-ECMO拔管后单把ProGlide缝合器止血的成功率和并发症发生率。结果：189例患者中，172例（91%）患者能达到单把Proglide快速止血。失败的主要原因是出血和假性动脉瘤，其中15例患者使用第二把ProGlide血管缝合器或8Fr Angio-seal血管封堵器达到成功止血，2例患者因局部血管并发症采用外科局部血管修复成功止血。结论：预置单把ProGlide血管缝合器在VA-ECMO管路建立与撤机时路径血管具有较高的安全性，能起到有效的止血效果。 |
| 英文摘要: |
| Abstract Objective: To investigate the safety of a single ProGlide vascular suture device in the management of access vessels during arteriovenous extracorporeal membrane oxygenation (VA-ECMO) cannulation and decannulation. Methods: A retrospective analysis was performed on the clinical data of 189 patients who underwent high-risk percutaneous coronary intervention (HR-PCI) supported by prophylactic VA-ECMO cannulation. The pre-suture technique with a single ProGlide vascular suture device (Abbott, USA) was applied to all femoral artery puncture sites. The hemostasis success rate and incidence of complications of the single ProGlide device after VA-ECMO decannulation were evaluated. Results: Among the 189 patients, 172 achieved rapid hemostasis with a single ProGlide device, with a hemostasis success rate of 91%. The main causes of failure were bleeding and pseudoaneurysm. A total of 15 patients achieved successful hemostasis with a second ProGlide vascular suture device or an 8Fr Angio-Seal vascular closure device (Terumo, Japan). There were two patients obtaining successful hemostasis via surgical salvage (local vascular repair) due to local vascular complications. Conclusion: Pre-deployment of a single ProGlide vascular suture device has favorable safety for access vessel management during VA-ECMO cannulation and decannulation, and can achieve effective hemostatic effect. |
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