Journal «Angiology and Vascular Surgery» • 

2016 • VOLUME 22 • №2

Prevention of postpuncture iatrogenic pseudoaneurysms of femoral arteries after coronary interventions for myocardial infarction

Fokin A.A.1,2, Kireev K.A.1,2, Moskvicheva M.G.2, Kireeva T.S.2

1) Railroad Clinical Hospital at the Chelyabinsk Station of the Joint-Stock Company "Russian Railways",
2) South Ural State Medical University of the RF Ministry of Public Health, Chelyabinsk, Russia

The study was aimed at analysing strategies of prevention of puncture-related complications in patients with myocardial infarction undergoing subjected to emergency coronary interventions by means of a femoral arterial access.

We carried out a retrospective comparative analysis of two strategies aimed at preventing false aneurysms of femoral arteries: Group One (232 cases) – elective use of special devices for closure of puncture defects in patients with high risk of haemorrhage (previously performed thrombolytic therapy; exogenous obesity of the second-third degree, 2-3 degree arterial hypertension, use of 2b/3a blood platelet receptors inhibitors); Group Two (525) cases – conventional routine use of these technologies. Puncture defects were closed using by means of devices Cordis Exoseal and St.Jude Angio-Seal.

The obtained results suggested advantage of the conventional approach: demonstrating a statistically significant (p<0.05) decrease in the total incidence of false aneurysms of femoral arteries (from 5.2 to 1.9%) and the frequency of cases requiring surgical suturing of the defect in the femoral artery (from 1.7 to 0.2%).

In the conditions of an intensive flow of emergency patients presenting with acute coronary pathology and requiring coronary interventions, devices for closing defects in the femoral arterial access make it possible to level puncture complications. Over the examined period of 2013-2014 there were performed more than 600 closures of defects of the femoral artery by means of the Cordis ExoSeal. These devices proved to be efficient, reliable, and very simple to use. A decrease in the incidence rate of puncture-related complications was also associated with rational prescription administration of drugs influencing positively various links of haemostasis.

KEY WORDS: percutaneous coronary interventions, acute myocardial infarction, pulsating haematoma, false aneurysm, device for closure of defect.

P. 144

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