PURPOSE Upper extremity and tibiopedal arterial access are increasingly used during endovascular therapies. Balloon compression hemostasis devices in these anatomic locations have been described, but most utilize a compression surface extending well beyond the puncture site. We report single-center experience with an arterial puncture-focused compression device following upper extremity and tibiopedal access. PATIENTS AND METHODS A series of 249 focused compression hemostasis devices (VasoStat, Forge Medical, Bethlehem, Pennsylvania, USA) were used in 209 patients following lower extremity (n = 63) and upper extremity (n = 186; radial: 90%) arterial access procedures using 4-7 French sheaths. Demographic, operative, and follow-up data were collected. Logistic regression was used to evaluate potential association between patient/operative variables and time to hemostasis. RESULTS Primary hemostasis was achieved in 97.2% (242/249) following sheath removal; in 7 cases (2.8%) puncture site oozing occurred after initial device removal and required reapplication. Secondary hemostasis was 100% (249/249). Seven complications (2.8%) were recorded: 5 minor hematomas (2%) and 2 transient access artery occlusions (0.8%). Mean time to hemostasis enabling device removal was 55 ± 28 min. Elevated body mass index (BMI) was not associated with increased time to hemostasis (p = 0.31). Accessed artery, sheath size, and heparin dose were also not associated with time to hemostasis (p = 0.64; p = 0.74; p = 0.75, respectively). CONCLUSIONS The focused compression hemostasis device enabled rapid hemostasis with a low complication rate. Time to hemostasis was independent of BMI, access site, sheath size, or heparin dose.

中文翻译：

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使用聚焦加压装置经皮介入治疗后的非股动脉止血。

目的在血管内治疗期间越来越多地使用上肢和胫骨动脉通路。已经描述了在这些解剖位置中的球囊压缩止血装置，但是大多数利用了远远延伸超出穿刺部位的压缩表面。我们报告了上肢和胫骨入路后使用以动脉穿刺为重点的加压装置的单中心经验。患者和方法209例患者在下肢（n = 63）和上肢（n = 186； radial骨：90％）的动脉中使用了249台聚焦加压止血装置（VasoStat，Forge Medical，伯利恒，美国）。使用4-7法式护套的出入程序。收集了人口，手术和随访数据。Logistic回归用于评估患者/手术变量与止血时间之间的潜在关联。结果鞘管切除术后原发止血率达到97.2％（242/249）。在7例（2.8％）的穿刺部位渗出发生在最初移除器械并需要重新使用之后。继发性止血为100％（249/249）。记录了7例并发症（2.8％）：5例轻度血肿（2％）和2例短暂进入动脉闭塞（0.8％）。止血的平均时间使器械移除时间为55±28分钟。体重指数（BMI）升高与止血时间增加无关（p = 0.31）。动脉通路，鞘管大小和肝素剂量也与止血时间无关（分别为p = 0.64； p = 0.74； p = 0.75）。结论聚焦加压止血装置可实现快速止血，并发症发生率低。止血时间与BMI，进入部位，鞘大小或肝素剂量无关。