This study aimed to assess the safety and feasibility of the ULtrasound-guided uSe Of exoSEAL technique (ULSOSEAL technique) in patients at a high risk of complications following the use of ExoSeal. ExoSeal is a novel, completely extravascular hemostatic device that can treat punctures of the common femoral artery; however, it is not preferable for use in cases that require hemostasis of complex puncture sites. From November 2019 to August 2020, the ULSOSEAL technique was performed in 35 patients with implanted stents (6 patients, 17%), severe calcification (32 patients, 91%), and plaque (7 patients, 20%) around the puncture site; the presence of these conditions is usually undesirable when using ExoSeal. The antegrade approach was used in 22 patients (71%). The size of the ExoSeal used was 5 Fr (13 patients, 37%), 6 Fr (21 patients, 60%), and 7 Fr (1 patient, 2%). Technical success was achieved in 34 patients (97%), while ExoSeal malfunction occurred in 1 patient. There was no incidence of vessel occlusion, pseudoaneurysm, arteriovenous fistula, infection, and secondary bleeding. One patient developed a hematoma (>5 cm in size); however, it occurred before the use of ExoSeal due to side leakage from the inserted sheath. The ULSOSEAL technique was safe and feasible for hemostasis in patients who were considered unsuitable for the ExoSeal device.

中文翻译：

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ULSOSEAL 技术：一种在普通股动脉穿刺后使用 ExoSeal 实现高危患者止血的独特技术

本研究旨在评估超声引导下使用 exoSEAL 技术（ULSOSEAL 技术）在使用 ExoSeal 后并发症风险高的患者中的安全性和可行性。ExoSeal 是一种新型的、完全血管外的止血装置，可以治疗股总动脉的穿刺；然而，它不适用于需要复杂穿刺部位止血的情况。2019年11月至2020年8月，对35例植入支架（6例，17%）、严重钙化（32例，91%）、穿刺部位周围斑块（7例，20%）的患者进行了ULSOSEAL技术；使用 ExoSeal 时，通常不希望出现这些情况。22 名患者 (71%) 使用了顺行方法。所用 ExoSeal 的尺寸为 5 Fr（13 名患者，37%）、6 Fr（21 名患者，60%）、和 7 Fr（1 名患者，2%）。34 名患者 (97%) 取得了技术成功，而 1 名患者发生了 ExoSeal 故障。无血管闭塞、假性动脉瘤、动静脉瘘、感染及继发性出血发生。一名患者出现血肿（> 5 cm）；然而，由于插入护套的侧漏，它发生在使用 ExoSeal 之前。ULSOSEAL 技术对于被认为不适合 ExoSeal 装置的患者止血是安全且可行的。它发生在使用 ExoSeal 之前，因为插入的护套有侧漏。ULSOSEAL 技术对于被认为不适合 ExoSeal 装置的患者止血是安全且可行的。它发生在使用 ExoSeal 之前，因为插入的护套有侧漏。ULSOSEAL 技术对于被认为不适合 ExoSeal 装置的患者止血是安全且可行的。