性对关动脉关闭装置与手动压缩在接受皮肤冠状动脉干预的患者的结果的影响
Wesley L Anderson1, Asad J Torabi1, Brian A O'leary1
1Department of Medicine, Division of Cardiovascular Medicine Indiana University School of Medicine Indianapolis Indiana USA.
Health science reports
|December 20, 2024
概括
通过皮肤冠状动脉干预 (PCI) 后,女性从股骨动脉关闭装置 (VCD) 中获益更多. VCD可以减少出血,血瘤和血管并发症,特别是在通过大腿部接入进行PCI的女性中.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 通过皮肤冠状动脉干预 (PCI) 进入大腿动脉仍然很常见,需要有效的血管关闭.
- 血管关闭装置 (VCD) 旨在减少关闭时间和出血并发症.
- 在关动脉关闭后的结果中,基于性别的差异需要进行调查.
研究的目的:
- 在接受PCI的患者中,评估与大腿动脉血管关闭装置 (VCD) 相关的性别特异性结果.
- 为了比较VCD的有效性和安全性与男性和女性的手动压缩.
主要方法:
- 来自印第安纳大学健康多中心心脏检查登记处的11415名患者的回顾性分析.
- 对VCD和手动压缩之间的临床结果进行比较,按性别分层.
- 排除患有心脏性休克或左心室支器械的患者.
主要成果:
- 与手动压缩相比,使用VCD与72小时出血事件的显著减少有关 (aOR:0.64;95%CI:0.46-0.87).
- 在手动压缩时,女性的72小时出血率较高 (男性为4.5%,男性为1.6%).
- 妇女在VCD出血的绝对风险降低较大 (2.8%对男性0.8%),同时出血的风险较低,出血点出血,血液瘤和血管并发症. 使用VCD也降低了住院死亡风险 (aOR:0.4;95%CI:0.28-0.58).
结论:
- 与男性相比,女性在PCI期间从股骨动脉VCD中获得更大的好处.
- 在接受PCI的女性中,VCD显著降低出血率,进入部位血液瘤和血管并发症.
- 这些发现支持在通过大腿接接受PCI的妇女中使用VCD,以改善安全结果.
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