관상동맥 중재술 후 Angioseal？ 사용하였던 환자에서대퇴동맥의 재사용 경험 = The Clinical Experience of Recannulation of Femoral Artery FollowingInitial Angioseal？ Use after Percutaneous Coronary Intervention

다국어 초록 (Multilingual Abstract)

Background and Objectives：The impact for recannulation of an artery, where a vascular closure device had beenused following percutaneous coronary intervention (PCI), has not been evaluated. The aim of this study was todetermine the feasibility and safety of recannulation of the femoral artery following the use of an Angioseal??following PCI. Subjects and Methods：Between February 2002 and June 2004, 110 patients (Group I: 60.0±9.0 years, 84 male), who underwent a 6-month follow-up coronary angiography (CAG) following PCI and theuse of an Angioseal?? closure device, were compared with a further 110 randomly assigned patients (Group II:61.4±9.2 years, 78 male), who received manual compression for femoral artery hemostasis following PCI duringthe same period. The occurrence of femoral puncture site complications, the time to active ambulation followingPCI and procedural difficulties for recannulation during the follow-up CAG were analyzed. Results：Thebaseline clinical characteristics and procedure related factors were similar between the two groups. No majorcomplications were noted in either group. There were no differences in the incidence of minor complications,including puncture site oozing or hematoma, between the two groups. The time to active ambulation was significantlyshorter in group I than II (7.2±2.7 vs. 17.3±4.2 hours, p=0.001). At the 6-month follow-up CAG,no major complications associated with re-puncture at the same site of the femoral artery were noted, andthere were no differences in the incidence of minor complications between the two groups. Conclusion：AnAngioseal?? was a convenient method of hemostasis, which promoted early ambulation without difficulties in thereuse of the femoral artery.

국문 초록 (Abstract)

배경 및 목적：경피적 관상동맥 중재술(percutaneous coronary intervention:PCI)이 증가됨에 따라 지혈을 위해 혈관 폐쇄 기구의 사용도 증가되어지고 있다. 그러나 혈관 폐쇄 기구를사용하여 지혈을 시행한 혈관에 대해 재천자 시에 미치는영향에 대한 평가는 이루어지지 않았다. PCI 후 지혈을 위해 Angioseal?瑛? 사용하였던 대퇴동맥에 대해 6개월 추적관상동맥 조영술 시에 재천자의 안정성 및 유용성에 대해알아보고자 하였다.방 법：2002년 2월부터 2004년 7월까지 PCI 후 Angioseal?瑛?이용하여 대퇴동맥의 지혈을 시행하였던 358명의 환자 중6개월 후 추적 관상동맥 조영술이나 중재술을 시행했던 110명의 환자(Ⅰ군: 60.0±9.0세)와 동일한 기간 동안 관상동맥 중재술 후 용수 압박법으로 지혈을 시행하고 6개월 후추적 관상동맥 조영술이나 중재술을 시행했던 110명의 환자를 무작위로 선정하여 대조군(Ⅱ군: 61.4±9.2세)으로 하여비교 분석하였다. PCI 후 대퇴동맥 천자부위에 발생하는 합병증 및 보행 개시까지 시간을 평가하였고, 추적 관상동맥조영술시 시술과 연관된 문제점들을 평가하였다.결 과：임상적인 특성이나 시술과 연관된 인자들은 두 군 간에 유사하였다. 두 둔 모두에서 주요한 합병증의 발생은 없었으며, 새어나오는 출혈이나 혈종과 같은 합병증의 발생도 두 군 간에 차이는 없었다. 그러나 지혈 후 보행 개시까지의 시간은 Ⅰ군에서 7.2±2.7시간, Ⅱ군에서 17.3±4.2시간으로서, Ⅰ군에서 유의하게 짧았다 (p=0.001). 6개월 후 추적 관상동맥 조영술이나 중재술시 같은 부위의 대퇴동맥 천자와 연관된 주요 합병증은 두 군 모두에서 없었으며, 새어나오는 출혈이나 혈종 등의 발생도 차이가 없었다.결 론：Angioseal?瑛? PCI 후 조기 보행을 가능하게 하여 편리하게 사용될 수 있는 지혈법이며, 6개월 후 추적 관상동맥 조영술 시에 Angioseal?瑛? 사용하였던 대퇴동맥의 재천자도부작용 없이 안전하게 시행 할 수 있었다.

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