
ResumenEl dispositivo de cierre de punción femoral Angio-Seal™ (St. Jude Medical, St. Paul, Minnesota) es actualmente el más utilizado en nuestro medio para el cierre de las punciones femorales en los que se utilizan introductores hasta 8F, con excelentes resultados, sin apenas complicaciones, y que permite una movilización precoz del paciente (incluso a las 3h del procedimiento).Dada la amplia experiencia en nuestro medio con dicho dispositivo, decidimos el inicio de un protocolo de retirada de los dispositivos de contrapulsación intraaórtica mediante el uso del Angio-Seal™ para la hemostasia. Todos los procedimientos se llevan a cabo en la unidad de cuidados intensivos cardiológicos. Desde el inicio del protocolo (junio de 2014 hasta septiembre de 2015) hemos realizado un total de 33 procedimientos de retirada de balón de contrapulsación intraaórtica con el dispositivo Angio-Seal™ 8F.Hemos incluido un total de 33 pacientes consecutivos (19 varones y 12 mujeres) con una edad media de 64,1 años (rango: 50-83) a los que se les ha implantado un dispositivo de contrapulsación intraaórtica por distintas causas.Como objetivo primario del estudio se ha incluido la ausencia de complicaciones mayores y únicamente una complicación menor (hematoma > 10 cm), siendo la efectividad en la liberación del dispositivo del 100.La retirada de los dispositivos de contrapulsación intraaórtica mediante el uso de Angio-Seal™ 8F para la hemostasia se considera un dispositivo rápido, efectivo y seguro, por lo que podemos recomendar su uso, aunque sería necesario un estudio con más pacientes y aleatorizado con respecto a la compresión manual tradicional para recomendar su uso rutinario.AbstractDue to the big experience with Angio-Seal™ Device (St. Jude Medical) in our center to close femoral puncture during cardiac catheterization, we investigated whether the Angio-Seal™ could be used safely and could achieve hemostasis fastly when removing an IABP.We prospectely studied 33 consecutive patients (Age: mean 64,1 years [50-83 years]) in which the Angio-Seal™ 8F device was planned to be used to achieve vascular hemostasis after removal of an IABP between January to December of 2015 in the Cardiac Intensive care unit of Cruces University Hospital. IABP was implanted due to several causes (cardiogenic shock due to STEMI, after cardiac surgery, high risk PCI...).The primary endpoint was a composite of any type of major (retroperitoneal bleeding, vessel occlusion, loss of distal pulses, vascular surgery and death) and minor vascular complication (hematoma, AV fistula or pseudoaneurism).IABP was continued for 1-7 days (mean 4 days). The device was successfully deployed in all of the patients. There were no major and only 2 minor complications (hematoma >10 cm). No patients required additional compression although most of them were treated with antiplatelet drugs.Removal of IABP with the Angio-Seal™ 8F device is a fast, effective and safe procedure that could improve the hemostasis and the confort of the patients compared with the manual compression or other compression decides. We need further randomized studies comparing Angio-Seal™ with conventional methods of compression to recommend routine use.
Balón de contrapulsación intraaórtico, Hemostasis, RD1-811, Angio-Seal™, R, Medicine, Surgery, Hemostasía, Intra-aortic balloon pumps
Balón de contrapulsación intraaórtico, Hemostasis, RD1-811, Angio-Seal™, R, Medicine, Surgery, Hemostasía, Intra-aortic balloon pumps
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