Applicazione percutanea di collagene (VASOSEAL): un\u2019efficace sistema di emostasi dopo cateterismo o procedure interventistiche per via arteriosa

Abstract

Introduction. The widespread use of PTCA and complex percutaneous interventional techniques has significantly increased peripheral vascular complications prompting the development of innovative hemostatic closure devices. Methods. To evaluate the efficacy and safety of a bovine collagen plug (VasoSeal), we sealed 362 consecutive femoral artery puncture sites in 324 patients (240 males) (mean age 57.9 \ub1 11.3 years), who underwent interventional procedures or diagnostic catheterization during acute or chronic anticoagulant treatment. Results. Complete hemostasis was achieved in 2.31 \ub1 1.97 minutes in 342 cases (94.4%), with a mean activated clotting time at collagen deployment of 197 \ub1 56''. In 20 cases, mechanical arterial compression was needed in order to obtain vascular hemostasis (mean time: 44 \ub1 13 min). We observed 1 arteriovenous fistula and 1 acute arterial thrombosis (collagen related at surgical inspection) which underwent successful surgical treatment. Minor complications without clinical sequelae were: small hematomas in 13 cases (3.8%), 4 groin abscesses (1.1%) and 4 cases of lymphangitis (1.1%). Conclusions. Percutaneous collagen application at the femoral artery puncture site allows quick and effective hemostasis with low incidence of peripheral vascular complications following interventional percutaneous procedures or catheterization during anticoagulant treatment