Management of post-puncture bleeding after neurointerventional procedures performed with a large-bore sheath introducer

Journal of Clinical Neuroscience Volume 74 Page 61-64 published_at 2020-01-27
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Title ( eng )
Management of post-puncture bleeding after neurointerventional procedures performed with a large-bore sheath introducer
Creator
Ozono Iori
Oshita Jumpei
Ishii Daizo
Source Title
Journal of Clinical Neuroscience
Volume 74
Start Page 61
End Page 64
Abstract
Various adjunctive techniques for neurointerventional procedures require a large-bore sheath introducer, but there is concern that this could result in more puncture site hemorrhagic complications despite using a vascular closure device. The purpose of this study was to assess the relationship between use of large-bore sheath introducer and post-procedural complications. Between January 2016 and April 2018, 126 neurointerventional procedures were performed in our hospital using 8 or 9 Fr sheath introducer in size and the Angio-Seal STS PLUS (St. Jude Medical, Minnetonka, USA). Hemorrhagic complications were defined as obvious swelling or bleeding at the puncture site or as extravascular bleeding detected by ultrasonography or contrast-enhanced computed tomography. The procedures were divided into a group with post-puncture bleeding (group B, n = 21) and a group without bleeding (group N, n = 105). Risk factors were compared between the groups according to the incidence of post-puncture bleeding. In addition, we assessed the outcome and approach to hemostasis in the procedures with bleeding. In result, hemorrhagic complications occurred in 21 procedures (17%), and pseudoaneurysm was detected in 4 procedures (3.2%). In 20 of group B (16%), manual compression was performed for an average of 36.4 min. One patient (0.79%) required surgical angioplasty. Risk factors for bleeding were not significantly different between the two groups. None of the patients with bleeding showed a decrease on the modified Rankin Scale. In conclusion, use of a large-bore sheath introducer may increase the incidence of post-puncture bleeding, but the outcome of this complication is acceptable.
Keywords
Angio-Seal
Hemorrhagic complication
Neurointervention
Language
eng
Resource Type journal article
Publisher
Elsevier
Date of Issued 2020-01-27
Rights
© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
This is not the published version. Please cite only the published version. この論文は出版社版ではありません。引用の際には出版社版をご確認、ご利用ください。
Publish Type Author’s Original
Access Rights open access
Source Identifier
[ISSN] 0967-5868
[DOI] 10.1016/j.jocn.2020.01.065
[DOI] https://doi.org/10.1016/j.jocn.2020.01.065