The Earlier Clinical Effect Analysis Of Vascular Closure Deviceproglide&Angioseal

Objective To observe the curative effect of vascular closure device closed femoral artery,and evaluate the effectiveness,safety and clinical practical value.Method With a prospective randomized controlled trial from Department of Vascular Surgery;People's Hospital of Xinjiang Uygur Autonomous Region.57 patients with large artery expansion of admission disease were collected for interventional operation in June 2014 to June 2015.There were 45 patients with abdominal aortic aneurysm and 12 patients with aortic dissection.Total puncture were 86 positions,including 64 with abdominal aortic aneurysm and 22 in aortic dissection.26 puncture positions were closed by Proglide &Angioseal,19 in that were abdominal aortic aneurysm;25 positions,included 20 abdominal aortic aneurysm were in the Two Proglides group;34 positions were in Surgical Femoral Cutdown group,which included 25 for abdominal aortic aneurysm pations.20 cases were collected with lower extremity arterial occlusive disease in patients,10 positions were used by Angioseal,and the last were cut.All the patients were diagnosed Clearly.For patients with the iliac artery lesions,the furcal stent was used for endovascular repair.Heparin anticoagulation therapy were unified.Stent was selected with Endurant(Medtronic,USA),which diameter is 18F-22 F.The Vascular Closure Device was selected with Perclose(Abbott Proglide America),Angioseal with 6F diameter(St.Jude;America).Gender,age,type of disease and other baseline characteristics and hypertension,diabetes,perioperative risk factors such as medication has no difference.The conditions for the use of Vascular Closure Device were as follows: preoperative computed tomography angiography(CTA)or intraoperative angiography showed that the femoral artery had no obvious stenosis and plaque and severely distorted.Informed consen were signed before the operation.Exclusion criteria was that: femoral artery had obvious atherosclerosis or stenosis severity,significant calcification or tortuosity;there was hematoma because of multiple drill hole;puncture point in femoral artery was lower than the crotch.Large artery group: patients followed the order to be deal with different closed methods(1)Angioseal & Proglide(2)Proglide cross stitch(3)femoral artery incision(Surgical Femoral Cutdown,the SFC).Lower extremity arteriosclerosis group(1)Angioseal(2)Surgical femoral cutdown,Sfc.Each operation was fixed andadequate supply of equipment.To use the closure according to the instructions strictly.The SPSS19.0 statistical softwarewas used for data.Normal distribution of measurement data showed by (?)±s,the overall use analysis of variance.By t or t approximate Test in groups.Enumeration data was compared with c2 Test.The skewness distribution data was showed by M(P25,P75)and the overall used Kruskal-Wallis H Test,and Mann-Whitney Test for in groups.There was statistical significance by P<0.05.Results The large arteries and arterioles groups: In Proglide & Angioseal group,bleeding time was less than the Two Proglides group and conventional incision group,(P < 0.05).In the amount of bleeding,ambulation time and postoperative pain,the two groups were not different(P > 0.05),which were better than the SFC group(P < 0.05).Angioseal closed the femoral artery,compared with the traditional way in the index above had advantages(P < 0.05);Each groups had no macrovascular complications,but in small vascular complications of subcutaneous errhysis and hematoma,there was no significant difference(P > 0.05).The study of Angioseal & Proglide group include 19 patients and 26 positions.The successful rate was 100%.The Two Proglides group had 17 patients and 20 positions,1 case was failure and dealed with pressurized bandaging treatment,the successful rate was 96.2%;In the SFC group,21 pations and34 positions were successful,but there was 1 case in postoperative bleeding.the reason was that the external force was suffered.By the inguinal region accidentally,there was no significant difference between the successful rate of each group(P > 0.05).There were no peritoneal bleeding,pseudoaneurysm,arteriovenous fistula and other major vascular complications.Conclusion Compared with the traditional methods of hemostasis,the Vascular Closure Device is better for clinical work.Proglide &Angioseal compared with conventional Proglides may has more advantages in the close of large hole.