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J Vasc Access ; 18(3): 264-268, 2017 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-26044902

RESUMO

INTRODUCTION: The AXERA 2 low-angle vascular access device utilizes a dual arteriotomy mechanism in which the standard access tract is compressed by a vascular sheath inserted over the second, low-angle tract. It is unknown whether this device could be effectively used with 21-gauge micropuncture access, as the micropuncture introducer makes a larger arteriotomy than the 19-gauge needle provided with the AXERA 2 system. MATERIALS AND METHODS: A retrospective review was performed on 189 patients who underwent common femoral artery access for diagnostic cerebrovascular angiography using either combined micropuncture and AXERA 2 access or standard access with manual pressure hemostasis. Demographic and procedural data were reviewed along with complications related to vascular access and times to bed elevation, ambulation and discharge. RESULTS: Combined micropuncture and AXERA 2 access was performed on 110 patients and 79 patients had standard access. The AXERA device was successfully used in 91.8% of the cases. Demographic data, anticoagulant use and sheath sizes were similar between both subsets. Use of the AXERA 2 was associated with two bleeding complications (1.8%) compared with 10 (12.7%) with manual pressure hemostasis alone. Institution-specific protocol allowed shorter mean manual compression time, as well as shorter times to ambulation and discharge with the AXERA 2. CONCLUSIONS: Use of the AXERA 2 device with micropuncture access did not infer increased bleeding risk than standard arterial access in this patient series. The considerable incidence of device use failures suggests a learning curve associated with its use.


Assuntos
Angiografia Cerebral/métodos , Artéria Femoral , Angiografia Cerebral/efeitos adversos , Angiografia Cerebral/instrumentação , Competência Clínica , Desenho de Equipamento , Falha de Equipamento , Artéria Femoral/diagnóstico por imagem , Hemorragia/etiologia , Hemorragia/prevenção & controle , Técnicas Hemostáticas , Humanos , Curva de Aprendizado , Punções , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Dispositivos de Acesso Vascular
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