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Impact of the Duett sealing device on quality of life and hospitalization costs for coronary diagnostic and interventional procedures: Results from the Study of Economic and Quality of Life substudy of the SEAL trial

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AMERICAN HEART JOURNAL 2001年第6期142卷 982-988页

作者： Zhang, Z Mahoney, EM Gershony, G Ellis, S Saucedo, JF Talley, JD Feldman, T Weintraub, WS Emory Univ Sch Med Div Cardiol Atlanta GA 30306 USA John Muir Med Ctr Walnut Creek CA USA Cleveland Clin Fdn Cleveland OH 44195 USA Univ Arkansas Med Sci Little Rock AR 72205 USA Cardiol Associates Paducah KY USA Univ Chicago Chicago IL 60637 USA

Background The Simple and Effective Arterial Closure (SEAL) trial examined the safety and effectiveness of the Duett vascular sealing device (Vascular Solutions, Minneapolis, Minn) versus manual compression after diagnostic and interventional coronary procedures. We compared quality of life and initial hospitalization costs among patients treated with the Duett device versus manual compression. Methods Functional status was assessed with the Duke Activity Status Index (DASI) at 7 and 30 days after intervention. General health status was assessed with the Short Form (SF-36) at 30 days after intervention. Hospitalization costs were derived from the UB92 formulation of the hospital bill. Results There was a strong trend toward higher functional status in patients receiving treatment with the Duett device at 7 days both before (P = .04) and after (P = .08) adjustment for significant covariates. This difference was significant in the diagnostic group but not in the interventional group. No significant differences in quality of life between the Duett device and manual compression at 30 days were found. There was no significant difference in total hospitalization costs between treatment arms (P = .91). For interventional patients, mean total in-hospital costs were $10,167 in the Duett group and $10,225 in the manual compression group (P = .82). For diagnostic patients, mean hospitalization costs were $7784 and $7996 for the Duett device and manual compression groups, respectively (P = .72). Trends toward reduced recovery/observation room costs with the Duett device (P = .06) were found;this difference was significant in the diagnostic group ($198 vs $279, P = .02). Conclusions The Duett sealing device was associated with significantly higher functional status at 7 days after the procedure in addition to shortened time to hemostasis and ambulation, with no associated increase in cost.

关键词：年龄因素血管成形术经腔经皮冠状动脉导管留置股动脉心脏导管插入术出血/预防和控制止血技术/仪器和设备住院时间/经济学穿刺术生活质量回归分析性别因素组织黏合剂治疗结果美国成年人女(雌)性人类男(雄)性中年人

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Scanning electron microscopy of hydroxylated polyvinyl acetal and conventional gauze strip nasal packing materials

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AMERICAN JOURNAL OF RHINOLOGY 2001年第2期15卷 91-94页

作者： Uslu, SS Ileri, F Köybasioglu, A Çelik, H Sargon, M Özbilen, S Gazi Univ Sch Med Dept Otorhinolaryngol Ankara Turkey

The application of nasal packing is one of the most commonly performed procedures in rhinology. Various materials have been used as nasal packing, including conventional gauze strips and hydroxylated polyvinyl acetal. Complications related to nasal packing may cause problems that lend to increased morbidity. Among those complications, infectious ones range from localized infection in the nasal cavity to toxic shock syndrome. The purpose of this study was to evaluate conventional gauze strips and hydroxylated polyvinyl acetal nasal packing materials by scanning electron microscopy to reveal their surface characteristics that would promote or prevent the development of infectious complications. The two types of materials were examined before and after application into the nasal cavity. Scanning electron microscopy demonstrated that hydroxylated polyvinyl acetal material had a smooth surface, whereas conventional gauze strips had an ii-regular surface with fibers projecting, thus increasing the surface area for bacterial adherence and allowing possible evasion of bacteria from the elements of the immune system within this fibrillar structure.

关键词：绷带鼻出血/治疗止血技术/仪器和设备羟基化显微镜检查电子扫描乙烯类聚合物/治疗应用人类

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Surgical complications from hemostatic puncture closure devices

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AMERICAN JOURNAL OF SURGERY 1999年第6期178卷 511-515页

作者： Eidt, JF Habibipour, S Saucedo, JF McKee, J Southern, F Barone, GW Talley, JD Moursi, M Univ Arkansas Med Sci Dept Surg Little Rock AR 72205 USA Univ Arkansas Med Sci Dept Cardiol Little Rock AR 72205 USA John L McClellan Mem Vet Adm Med Ctr Little Rock AR 72205 USA

BACKGROUND: For securing immediate hemostasis following percutaneous arterial catheterization, the Food and Drug Administration has approved three hemostatic puncture closure devices. We reviewed our institutional experience with one device (Angio-Seal). METHODS: A retrospective, single-center, nonrandomized observational study was made of all vascular complications following femoral cardiac catheterization. RESULTS: An immediate mechanical failure of the device was experienced in 34 (8%) patients. Surgical repair was required in 1.6% (7 of 425) of patients following Angio-Seal versus 0.3% (5 of 1662) following routine manual compression (P = 0.004). In 5 patients, the device caused either complete occlusion or stenosis of the femoral artery. The polymer anchor embolized in 1 patient and was retrieved with a balloon catheter at surgery. CONCLUSION: During the first year of utilization of a percutaneous hemostatic closure device following cardiac catheterization, we observed a marked increase in arterial occlusive complications requiring surgical repair. Surgeons must be familiar with the design of these devices to achieve precise repair of surgical complications. Am J Surg. 1999;178:511-516. (C) 1999 by Excerpta Medica, Inc.

关键词：动脉闭塞性疾病/病因学动脉闭塞性疾病/外科学设备设计股动脉心脏导管插入术/仪器和设备止血技术/仪器和设备穿刺术回顾性研究美国美国食品和药物管理局女(雌)性人类男(雄)性中年人

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Management of severe postnasal haemorrhage: the Kingsley splint revisited

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BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY 2000年第4期38卷 264-266页

作者： Sherman, JA Tate, RJ Ipswich Hosp NHS Trust Dept Oral & Maxillofacial Surg Suffolk England

Postnasal haemorrhage accompanying severe craniofacial trauma may have catastrophic consequences if not arrested promptly. The airway has usually been secured acid the cervical spine stabilized, but apart from fluid replacement, other attempts to control haemorrhage in the resuscitation room of the accident and emergency department may be to no avail. We wish to draw attention to a simple device that was introduced over 100 years ago and which may rapidly aid haemostasis and prevent the onset of hypovolaemic shock.

关键词：颅脑损伤/并发症颅脑损伤/治疗鼻出血/病因学鼻出血/治疗设备设计致命性结局骨折粉碎性/并发症骨折粉碎性/治疗止血技术/仪器和设备颅骨骨折/并发症颅骨骨折/治疗夹板成年人人类男(雄)性

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Comparison of major complication rates associated with four methods of arterial closure

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AMERICAN JOURNAL OF CARDIOLOGY 2000年第8期85卷 1024-+页

作者： Shrake, KL St Johns Mercy Med Ctr Adm St Louis MO 63141 USA

This study revealed a statistically significant difference in major complication rates associated with the 4 methods of arterial closure. Angio-Seal had the highest incidence of major complications (3.2%), whereas Vas... 详细信息

关键词：心脏导管插入术止血技术/仪器和设备发病率前瞻性研究人类

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A sprayable hemostat containing fibrillar collagen, bovine thrombin, and autologous plasma

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ANNALS OF THORACIC SURGERY 1999年第2期68卷 479-485页

作者： Prior, JJ Wallace, DG Harner, A Powers, N Cohes Technol Inc Palo Alto CA 94303 USA

Background. A new sprayable hemostat, CoStasis hemostatic device (Cohesion Technologies Inc, Pale Alto, CA), consisting of collagen, thrombin, and autologous plasma was tested versus fibrin sealant and collagen hemostatic sponges. Performance was also monitored as fibrinogen and platelets were depleted from the plasma. In addition, the strength of the CoStasis gel, its sealing ability, its fibrillar structure, and its platelet-aggregating ability were investigated. Methods. Hemostatic performance was determined with an in vivo bleeding rabbit kidney and spleen model. Differential scanning calorimetry and electron microscopy were used to analyze collagen structure. Sealing ability was determined with a burst-test apparatus. Results. In the in vivo model, CoStasis was superior to fibrin sealant and collagen sponges in achieving a rapid time to hemostasis. The formulation continued to perform well when either platelets or fibrinogen was depleted. CoStasis formed weaker gels than fibrin sealant and could withstand only modest pressures. The collagen in the formulation had a fibrillar structure that was shown to aggregate human platelets. Conclusions. CoStasis, with the two platelet activators collagen and thrombin in addition to the thrombin-catalyzed formation of fibrin and the sealing properties of the soft gel, provides an excellent atraumatic hemostat. (C) 1999 by The Society of Thoracic Surgeons.

关键词：气雾剂胶原/药理学设备设计纤维蛋白组织黏着剂/药理学纤维蛋白原/药理学止血技术/仪器和设备止血药/药理学肾/外科学显微镜检查电子血浆血小板计数脾/外科学凝血酶/药理学动物牛人类兔

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冠状动脉介入治疗术后应用桡动脉压迫器的护理

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中国误诊学杂志 2007年第20期7卷 4888-4889页

作者：王湘君熊国凤王淑琴郑州大学第五附属医院介入科河南郑州450052

我院2005-01－2007-03采用桡动脉压迫器对210例冠状动脉介入术后桡动脉穿刺点进行压迫止血处理,取得了满意的效果,与传统压迫方法相比,术后并发症的发生率明显减少,患者的舒适度显著改善,护理体会如下。[第一段]

关键词：心脏导管插入术/护理手术后医护桡动脉止血技术/仪器和设备人类

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冠脉介入术后Angio-Seal血管闭合器与徒手压迫止血方法的对比分析

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中国误诊学杂志 2006年第1期6卷 31-32页

作者：郑铿古京红四川省成都市第一人民医院心内科 610016

近几年来,Anglo-Seal闭合器在国外逐渐广泛应用,取得了一定的效果。我科2004—08－2005—07应用Anglo-Seal闭合器以来,至今已有21例患者应用。本研究旨在比较Anglo-Seal闭合器止血方法的安全性和有效性.现报道如下。[第一段]

关键词：血管成形术经腔经皮冠状动脉止血技术/仪器和设备止血技术/方法

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可调式头皮压迫止血器的研制及临床应用

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中国误诊学杂志 2008年第30期8卷 7545-7546页

作者：姜桂喜刘玉华王明民山东省青岛市海慈医疗集团血管外科 266033 青岛钢铁集团公司医院山东青岛266043 山东省青岛市中心医院 266043

创口出血是最常见的临床病症,及时有效地止血,尤其是手术过程中有效止血可减轻患者痛苦,缩短手术时间,提高手术质量,防止出现失血性休克,有利于患者康复。目前,肢体用止血带及止血器已广泛应用于临床,但迄今为止,对头部创口出血,仍沿用... 详细信息

创口出血是最常见的临床病症,及时有效地止血,尤其是手术过程中有效止血可减轻患者痛苦,缩短手术时间,提高手术质量,防止出现失血性休克,有利于患者康复。目前,肢体用止血带及止血器已广泛应用于临床,但迄今为止,对头部创口出血,仍沿用手压、钳夹等止血方法,其止血不全,影响术者操作,从而影响手术质量。基于临床工作需要,我们研制了一种头部实用新型止血器械,在头部创口的治疗过程中取得了满意的效果。[第一段]

关键词：止血技术/方法止血技术/仪器和设备

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脑血管造影术后解除动脉压迫止血器最佳时间分析

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中国误诊学杂志 2011年第35期11卷 8633-8634页

作者：吴雪影赵永娟陈淑良栾桂君大连医科大学附属第二医院神经内科辽宁大连116027

目的探讨脑血管造影术后,解除股动脉压迫止血器的最佳时间。方法将298例经股动脉穿刺行脑血管造影的患者随机分为两组,均使用YM-GU-1229型动脉压迫止血器,实验组使用后3h松解半圈,6h完全松解,对照组每隔3h松解半圈,9h完全松解。均观察2... 详细信息

目的探讨脑血管造影术后,解除股动脉压迫止血器的最佳时间。方法将298例经股动脉穿刺行脑血管造影的患者随机分为两组,均使用YM-GU-1229型动脉压迫止血器,实验组使用后3h松解半圈,6h完全松解,对照组每隔3h松解半圈,9h完全松解。均观察2h穿刺部位无出血,解除压迫止血器。比较两组差异。结果两组穿刺部位出血、血肿及腹胀比较差异无统计学意义(P>0.05)。局部皮肤损害、排尿困难及腰背部疼痛比较有统计学意义(P<0.05)。结论提前3h解除压迫止血器可减少局部皮肤损害,降低排尿困难、疼痛的发生,不会提高穿刺部位出血、血肿发生率。

关键词：脑血管造影术止血技术/仪器和设备时间因素

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