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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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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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Collagen-thrombin-plasma composite hemostat

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ANNALS OF THORACIC SURGERY 2000年第4期69卷 1298-1299页

作者： Robicsek, F Carolinas Heart Inst Dept Cardiovasc & Thorac Surg Charlotte NC 28203 USA

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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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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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Complications associated with percutaneous closure devices

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AMERICAN JOURNAL OF SURGERY 1999年第3期178卷 209-211页

作者： Gonze, MD Sternbergh, WC Salartash, K Money, SR Ochsner Med Inst Dept Surg Vasc Surg Sect New Orleans LA 70121 USA

BACKGROUND: In an effort to reduce time to hemostasis after angiography, several closure devices have been marketed. We report some of their complications. METHODS: A retrospective review was conducted. RESULTS: Over an 8-month study period, 2,181 diagnostic and interventional procedures were performed. Closure devices were used in 408 (19%) of these patients. The Angio-Seal closure device is composed of a collagen sponge and an absorbable polymer anchor that compresses the hole in the arteriotomy. The ProstarXL sealing device consists of a rotating barrel that deploys 4 needles through the arteriotomy, and then individual knots are extracorporeally tied. The Duett device consists of a balloon occluding catheter and injectable collagen and thrombin. Ten of the patients developed a complication from the closure device (2.5%). Four of these were subcutaneous abscesses. Two of these patients had expanding pseudaneurysms, 2 had lower extremity ischemia, and 1 patient had an acute bleed. These complications were all managed surgically. Another patient developed a retroperitoneal bleed that was managed nonoperatively. CONCLUSIONS: AS the use of these devices increase, these complications will become more common. (C) 1999 by Excerpta Medica, Inc.

关键词：止血技术/仪器和设备回顾性研究缝合技术/仪器和设备人类

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