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Hämostatischer Verschluß der arteriellen Punktionsstelle mittels Angio-Seal™ nach diagnostischer Herzkatheteruntersuchung oder Koronarintervention

Hemostatic puncture closure using Angio-Seal™ after diagnostic cardiac catheterization or coronary angioplasty

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Zusammenfassung

Die konventionelle manuelle Kompression mit anschließendem Druckverband zum Verschluß der arteriellen Punktionsstelle nach diagnostischer Herzkatheteruntersuchung oder Koronarintervention ist mit einer mehrstündigen Immobilisation des Patienten verbunden. Die routinemäßige Antikoagulation sowie der Einsatz großlumiger Schleusen und Plättcheninhibitoren sind von einer erhöhten Inzidenz lokaler Blutungskomplikationen begleitet. Die sofortige Schleusenentfernung noch auf dem Kathetertisch mit sicherem Verschluß der Punktionsstelle ist wünschenswert und führt zu einem gesteigerten Wohlbefinden des Patienten. Das Angio-Seal™-System basiert auf einem hämostatischen Verschluß der Punktionsstelle mittels resorbierbarem Anker und Kollagenpfropf. In mehreren Studien wurden die Sicherheit und Effektivität des Systems dokumentiert. Dabei werden Erfolgsraten zwischen 88 und 100% berichtet. Signifikant reduzierte Hämostasezeiten ermöglichen eine frühzeitigere Mobilisation und verkürzte stationäre Aufenthaltsdauer des Patienten im Vergleich zur manuellen Kompression, ohne daß Komplikationen vermehrt auftraten.

Abstract

Conventional manual compression and subsequent application of pressure bandages is associated with prolonged immobility and significant patient discomfort. Routine anticoagulation as well as the use of new interventional devices and platelet inhibiting strategies lead to a higher incidence of local bleeding complications after diagnostic cardiac catheterization or coronary angioplasty. Immediate sheath removal increases patient comfort.

The Angio-Seal™ system uses a biodegradable anchor and collagen plug for sealing of arterial puncture sites. Several studies showed the safety and efficacy of this device. Technical deployment success ranges between 88 and 100%. Significant reduction in time to hemostasis allows for earlier patient ambulation and shorter in-hospital stay compared to manual compression with peripheral complications not being increased.

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Authors and Affiliations

  1. Abtedung für Kardiologie, Zentrum für Innere Medizin, Universitätsklinikum, Hufelandstraße 55, D-45122, Essen

    Holger Eggebrecht, Michael Haude, Dietrich Baumgart, Olaf Oldenburg, Jörg Herrmann, Christian Bruch, Peter Hunold, Claus Neurohr, Clemens von Birgelen, Dirk Welge, Marc -Alexander Katz & Raimund Erbel

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  1. Holger Eggebrecht
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  2. Michael Haude
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Correspondence to Holger Eggebrecht.

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Eggebrecht, H., Haude, M., Baumgart, D. et al. Hämostatischer Verschluß der arteriellen Punktionsstelle mittels Angio-Seal™ nach diagnostischer Herzkatheteruntersuchung oder Koronarintervention. Herz 24, 607–613 (1999). https://doi.org/10.1007/BF03044484

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