アルギン酸カルシウム含有の止血パッドを使用した脳血管内治療時の穿刺部止血

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  • 片山 正輝
    東京歯科大学市川総合病院　脳神経外科
  • 美原 貫
    東京歯科大学市川総合病院　脳神経外科
  • 島本 佳憲
    東京歯科大学市川総合病院　脳神経外科
  • 菅 貞郎
    東京歯科大学市川総合病院　脳神経外科

書誌事項

タイトル別名
  • Puncture site hemostasis using hemostasis-pad consisting of calcium alginate after neuroendovascular surgery
  • アルギンサン カルシウム ガンユウ ノ シケツ パッド オ シヨウ シタ ノウ ケッカン ナイ チリョウジ ノ センシブ シケツ

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説明

Objective: We investigated the efficacy and safety of the calcium alginate hemostasis-pad TricellTM (Alliance Medical Group, Tokyo) for puncture site hemostasis after neuroendovascular surgery.<br>Materials and Methods: Puncture site hemostasis using the TricellTM was examined in 12 patients undergoing neuroendovascular surgery between March 2011 and July 2011 in our institute. We evaluated the relationship of hemostasis time to introducer sheath size, use of antiplatelet agents and anticoagulants, and activated clotting time (ACT) just before removal of the introducer sheath.<br>Results: Hemostasis was achieved at the puncture site, which was the femoral artery, in all patients (4 women and 8 men; average age 68.8 years [range, 63 to 83]). As to introducer sheath size, 9Fr, 8Fr, 7Fr, 6Fr, and 5Fr sheaths were used in 3, 1, 4, 3, and 1 cases, respectively. There were 7, 2, 2, and 1 cases, respectively, of cerebral aneurysm, internal carotid artery stenosis, acute cerebral infarction, and brain tumor. Time to hemostasis was approximately 5-12 minutes, maximum 43 minutes. Two, two, and one patients required 3, 2, and 1 types of antiplatelet agents and anticoagulants, respectively, before neuroendovascular surgery. One patient required intravenous tPA and 6 patients required neither antiplatelet agents nor anticoagulants. The ACT just before introducer sheath removal was 107-286 seconds. Puncture site hemostasis was achieved within 10 minutes, when the introducer sheath size was 8Fr or smaller, no more than 2 antiplatelet agents or anticoagulants were taken preoperatively, and ACT just before introducer sheath removal was less than 250 seconds. No painful hematomas were observed.<br>Conclusion: Puncture site hemostasis using a calcium alginate containing hemostasis-pad after neuroendovascular surgery is effective and safe.

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 6 (3), 151-156, 2012

    一般社団法人 日本脳神経血管内治療学会

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