I Kalaja, R R Smeets, M Wegner, S Macherey-Meyer, S Heyne, C Espinola-Klein, Barend M E Mees, Max M Meertens
{"title":"经股动脉内手术后超声引导与传统闭合装置部署：一项系统综述和荟萃分析。","authors":"I Kalaja, R R Smeets, M Wegner, S Macherey-Meyer, S Heyne, C Espinola-Klein, Barend M E Mees, Max M Meertens","doi":"10.1016/j.ejvs.2025.06.023","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Femoral access site complications influence short term survival and outcomes in patients undergoing endovascular procedures. While ultrasound guided puncture is a reliable method to reduce such complications, ultrasound guidance is rarely utilised for closure device deployment.</p><p><strong>Data sources: </strong>Web of Science, PubMed, and the Cochrane Library.</p><p><strong>Review methods: </strong>A systematic literature search was conducted to assess the safety and efficacy of ultrasound guided vascular closure device deployment compared with vascular closure device deployment without ultrasound guidance, referred to as conventional closure. All studies reporting on ultrasound guided closure in transfemoral arterial interventions were eligible, and those directly comparing ultrasound guided with conventional closure were included in the meta-analysis.</p><p><strong>Results: </strong>Overall, 2 738 patients receiving ultrasound guided closure were included: 1 025 for introducer sheaths measuring 12 F or larger and 1 713 for introducer sheaths smaller than 12 F. The incidence of access complications was 5.7% (0.8 - 21.6%) for large sheath procedures and 2.6% (0.9 - 4.7%) for small sheath procedures. The meta-analysis, which included 2 339 patients who received ultrasound guided closure and 1 175 who underwent conventional closure, showed that ultrasound guided closure was associated with reduced access site complications compared with conventional closure (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.37 - 0.65; p < .001). This was consistently seen both for small sheath (OR 0.45, 95% CI 0.28 - 0.75; p = .002) and large sheath procedures (OR 0.50, 95% CI 0.37 - 0.71; p < .001), but with a low certainty of evidence in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) analysis.</p><p><strong>Conclusion: </strong>Ultrasound guided vessel closure of the femoral artery appeared to be associated with a lower rate of overall access site complications compared with conventional closure techniques. Therefore, ultrasound guided closure might offer the potential to increase procedural and patient safety in percutaneous arterial access.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"SYSTEMATIC REVIEW Ultrasound Guided versus Conventional Closure Device Deployment following Transfemoral Endovascular Procedures: A Systematic Review and Meta-analysis.\",\"authors\":\"I Kalaja, R R Smeets, M Wegner, S Macherey-Meyer, S Heyne, C Espinola-Klein, Barend M E Mees, Max M Meertens\",\"doi\":\"10.1016/j.ejvs.2025.06.023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Femoral access site complications influence short term survival and outcomes in patients undergoing endovascular procedures. While ultrasound guided puncture is a reliable method to reduce such complications, ultrasound guidance is rarely utilised for closure device deployment.</p><p><strong>Data sources: </strong>Web of Science, PubMed, and the Cochrane Library.</p><p><strong>Review methods: </strong>A systematic literature search was conducted to assess the safety and efficacy of ultrasound guided vascular closure device deployment compared with vascular closure device deployment without ultrasound guidance, referred to as conventional closure. All studies reporting on ultrasound guided closure in transfemoral arterial interventions were eligible, and those directly comparing ultrasound guided with conventional closure were included in the meta-analysis.</p><p><strong>Results: </strong>Overall, 2 738 patients receiving ultrasound guided closure were included: 1 025 for introducer sheaths measuring 12 F or larger and 1 713 for introducer sheaths smaller than 12 F. The incidence of access complications was 5.7% (0.8 - 21.6%) for large sheath procedures and 2.6% (0.9 - 4.7%) for small sheath procedures. The meta-analysis, which included 2 339 patients who received ultrasound guided closure and 1 175 who underwent conventional closure, showed that ultrasound guided closure was associated with reduced access site complications compared with conventional closure (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.37 - 0.65; p < .001). This was consistently seen both for small sheath (OR 0.45, 95% CI 0.28 - 0.75; p = .002) and large sheath procedures (OR 0.50, 95% CI 0.37 - 0.71; p < .001), but with a low certainty of evidence in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) analysis.</p><p><strong>Conclusion: </strong>Ultrasound guided vessel closure of the femoral artery appeared to be associated with a lower rate of overall access site complications compared with conventional closure techniques. Therefore, ultrasound guided closure might offer the potential to increase procedural and patient safety in percutaneous arterial access.</p>\",\"PeriodicalId\":55160,\"journal\":{\"name\":\"European Journal of Vascular and Endovascular Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2025-06-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Vascular and Endovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ejvs.2025.06.023\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Vascular and Endovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ejvs.2025.06.023","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
SYSTEMATIC REVIEW Ultrasound Guided versus Conventional Closure Device Deployment following Transfemoral Endovascular Procedures: A Systematic Review and Meta-analysis.
Objective: Femoral access site complications influence short term survival and outcomes in patients undergoing endovascular procedures. While ultrasound guided puncture is a reliable method to reduce such complications, ultrasound guidance is rarely utilised for closure device deployment.
Data sources: Web of Science, PubMed, and the Cochrane Library.
Review methods: A systematic literature search was conducted to assess the safety and efficacy of ultrasound guided vascular closure device deployment compared with vascular closure device deployment without ultrasound guidance, referred to as conventional closure. All studies reporting on ultrasound guided closure in transfemoral arterial interventions were eligible, and those directly comparing ultrasound guided with conventional closure were included in the meta-analysis.
Results: Overall, 2 738 patients receiving ultrasound guided closure were included: 1 025 for introducer sheaths measuring 12 F or larger and 1 713 for introducer sheaths smaller than 12 F. The incidence of access complications was 5.7% (0.8 - 21.6%) for large sheath procedures and 2.6% (0.9 - 4.7%) for small sheath procedures. The meta-analysis, which included 2 339 patients who received ultrasound guided closure and 1 175 who underwent conventional closure, showed that ultrasound guided closure was associated with reduced access site complications compared with conventional closure (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.37 - 0.65; p < .001). This was consistently seen both for small sheath (OR 0.45, 95% CI 0.28 - 0.75; p = .002) and large sheath procedures (OR 0.50, 95% CI 0.37 - 0.71; p < .001), but with a low certainty of evidence in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) analysis.
Conclusion: Ultrasound guided vessel closure of the femoral artery appeared to be associated with a lower rate of overall access site complications compared with conventional closure techniques. Therefore, ultrasound guided closure might offer the potential to increase procedural and patient safety in percutaneous arterial access.
期刊介绍：
The European Journal of Vascular and Endovascular Surgery is aimed primarily at vascular surgeons dealing with patients with arterial, venous and lymphatic diseases. Contributions are included on the diagnosis, investigation and management of these vascular disorders. Papers that consider the technical aspects of vascular surgery are encouraged, and the journal includes invited state-of-the-art articles.
Reflecting the increasing importance of endovascular techniques in the management of vascular diseases and the value of closer collaboration between the vascular surgeon and the vascular radiologist, the journal has now extended its scope to encompass the growing number of contributions from this exciting field. Articles describing endovascular method and their critical evaluation are included, as well as reports on the emerging technology associated with this field.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
