[rsp]

В преддверии появления соглашения по этим "чудо-устройствам"
(AHA Statement Offers Guidance on Arterial Closure Device Use) уже появились [Ссылки доступны только зарегистрированным пользователям ]. Ждем выхода полнотекстовой версии.

While the use of arterial closure devices after cardiac catheterization may improve patient comfort, they should not be used routinely to reduce vascular complications since the jury is still out on whether these devices actually accomplish that, according to a new scientific statement from the American Heart Association (AHA) published online October 4, 2010, ahead of print in Circulation.

After weighing the current evidence on closure devices, the authors offer several additional recommendations:
- Patients who are potential candidates for closure devices during femoral access should undergo a femoral angiogram to identify the sheath-insertion site and other features such as atherosclerosis and calcification to ensure anatomic suitability (Class I; Level of Evidence C)
- Centers using standard manual compression regimens should aim to achieve vascular complications rates below 1% in patients undergoing uncomplicated 5 Fr diagnostic angiography (Class I; Level of Evidence C)
- Use of closure devices is “reasonable” after PCI performed via the femoral artery as a means to achieve faster hemostasis and shorter duration of bed rest, and possibly increase patient comfort. But the risk/benefit equation should take into account factors including age, gender, sheath size, and presence of systemic disease (Class IIa; Level of Evidence B)
- Closure devices “should not be used routinely for the specific purpose of reducing vascular complications” in patients undergoing femoral access PCI (Class III; Level of Evidence B)
- Data on periprocedural and postprocedural complications should be collected either locally or nationally, and reported to the US Food and Drug Administration (Class I; Level of Evidence C)