Jugular Vascular Closure and Scar Formation after Leadless Pacemaker Implantation.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2024-12-16 eCollection Date: 2024-12-01 DOI:10.31083/j.rcm2512440
Shmaila Saleem-Talib, Crispijn P R Hoevenaars, Vincent J van Driel, Harry van Wessel, Jeroen van der Heijden, Hemanth Ramanna, Natasja M S de Groot
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引用次数: 0

Abstract

Background: Achieving hemostasis of large bore venous access sites can be challenging and time consuming. Closure devices have proven to be superior in achieving hemostasis, reducing time to ambulation and improving patient comfort, compared to manual hemostasis techniques after femoral venous and arterial access. The closure of the jugular vein following large bore access has not been investigated in previous studies. In addition, scar formation of the neck after large bore access of the jugular vein has not been investigated. In this study, the safety and feasibility of the double Perclose ProGlide (PP), for achieving hemostasis of the internal jugular vein (IJV) following large bore access with 27 French Micra Transcatheter Pacemaker System (TPS) was examined. Also, the scar formation in the neck after IJV closure was examined during follow-up.

Methods: 136 consecutive patients from May 2018 until June 2024, in whom the IJV was closed with a double PP, following Micra TPS implantation were included. All patients were examined for hemostasis of the IJV and vascular complications, resulting in additional interventions. Time to ambulation, discharge and patient discomfort were also assessed. During follow-up the scar formation of the neck was examined.

Results: In all patients, the double PP was successful in achieving acute hemostasis of the IJV after large bore access. In all patients, 2 PP were deployed without device failure. One patient required additional manual pressure due to a minor hematoma. Ultrasound guided examination did not reveal any vascular complications. All patients were ambulated immediately. During follow-up, the scar in the neck was hardly visible.

Conclusions: Although the PP was designed as a closure device for femoral venous and arterial access, our data suggest that the PP can be used safely as a closure device for the IJV to achieve acute hemostasis, facilitate direct ambulation and improve patient comfort.

无铅起搏器植入后颈静脉闭合与瘢痕形成。
背景:实现大口径静脉通路的止血是具有挑战性和耗时的。与股静脉和动脉进入后的手动止血技术相比,封闭装置已被证明在止血、减少走动时间和改善患者舒适度方面具有优越性。在以前的研究中,没有对大口径通路后颈静脉的闭合进行过调查。此外,颈静脉大孔进入后颈部瘢痕形成尚未研究。在这项研究中,研究了双Perclose ProGlide (PP)在27法国Micra经导管起搏器系统(TPS)大口径通路后实现颈内静脉(IJV)止血的安全性和可行性。此外,随访期间检查了IJV闭合后颈部瘢痕形成情况。方法:纳入2018年5月至2024年6月连续136例Micra TPS植入术后双PP闭合IJV患者。所有患者都检查了IJV的止血情况和血管并发症,并进行了额外的干预。还评估了行走时间、出院时间和患者不适程度。随访期间检查颈部瘢痕形成情况。结果:在所有患者中,双PP都成功地实现了大孔置入后IJV的急性止血。在所有患者中,2个PP均未出现设备故障。一名患者由于轻微血肿需要额外的手压。超声引导检查未发现血管并发症。所有的病人都立即得到了救护。随访期间,颈部瘢痕几乎不可见。结论:虽然PP被设计为股静脉和股动脉通道的封闭装置,但我们的数据表明,PP可以安全地用作IJV的封闭装置,以实现急性止血,方便直接行走,提高患者的舒适度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
期刊介绍: RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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