Comparison of Femoral Artery Intervention Location After Coronary Angiography Using Sand Bag and Closure Device

Yıl 2017, Cilt: 9 Sayı: 5, 1 - 5, 28.09.2017

Osman Bektaş

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

Coronary angiography, closure device

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

Koroner anjiografi, kapamacihazı

Kaynakça

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