Local hemostasis during endovascular interventions

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Endovascular techniques are an important part of modern surgery , proven to be effective in the diagnosis and treatment of neoplastic
processes , diseases of the heart and blood vessels , surgical infections and bleeding. Research continues to develop equipment
manipulations , optimal drug prevention schemes , various methods of vascular imaging , devices for closing defects arteries and
others. The article reflects the relevance of the use of endovascular interventions , and historical aspects of local complications of
this technology . Particular attention was paid to the authors of hemorrhagic complications arising in the artery catheterization
with a frequency of 1.5 to 9 %. The article indicated predisposing local factors of complications , such as advanced age , presence
of anatomical features of the structure , blood diseases , heart, diabetes , obesity, renal failure , atherosclerosis, polimorbitnoy
pathology; In particular , only the risk of bleeding complications in patients age may reach 9 % or more. The article lists the
triggers of hemorrhagic complications after arterial puncture: the use of anticoagulant, thrombolytic and antiplatelet therapy,
repeated surgeries, prolonged exposure introdyussera in the artery, the use of instruments larger than 7 Fr, insufficient experience
of the operator and thoroughness puncture and subsequent hemostasis and others. Authors reduce the number slozhneny allows
professional staff , ultrasonic testing , which should be used in patients with hip circumference of 60 cm, in cases when impossibility
of determining the pulsation of the artery. The article presents the classification of devices for local hemostasis , according to which
the isolated compression , ligation , and klipiruyuschie occlusive device summarizes characteristics specific devices , presented
how they work , given the positive and negative aspects of their application. The results of the use of devices for hemostasis in the
literature are very contradictory and insufficient , which requires further study the effectiveness of their use in different groups of

About the authors

N.N. Burdenko Voronezh State Medical University, 10 Studencheskaia Str., Voronezh, 394036,
Russian Federation

Author for correspondence.
Email: admin@vestnik-surgery.com
д.м.н., проф. кафедры общей хирургии Воронежского государственного медицинского унирситета им. Н.Н.Бурденко

Voronezh regional clinical Oncology dispensary, Russia, 394036, Voronezh, street Vaitsekhovskaya, d. 4

Email: admin@vestnik-surgery.com
д.м.н., малоинвазивный хирург Воронежского областного клинического онкологического диспансера

N.N. Burdenko Voronezh State Medical University, 10 Studencheskaia Str., Voronezh, 394036,
Russian Federation

Email: admin@vestnik-surgery.com
д.м.н., проф., зав. кафедрой общей хирургии Воронежского государственного медицинского университета им. Н.Н.Бурденко.

Voronezh regional clinical Oncology dispensary, Russia, 394036, Voronezh, street Vaitsekhovskaya, d. 4

Email: admin@vestnik-surgery.com
врач Воронежского областного клинического онкологического диспансера

N.N. Burdenko Voronezh State Medical University, 10 Studencheskaia Str., Voronezh, 394036,
Russian Federation

Email: admin@vestnik-surgery.com
ассистент кафедры общей хирургии Воронежского государственного медицинского университета им. Н.Н.Бурденко


  1. Atanesian R.V. Matchin Iu.G. Loktevoi arterial'nyi dostup:
  2. vynuzhdennaia al'ternativa luchevomu dostupu ili samostoiatel'nyi
  3. operativnyi dostup dlia provedeniia interventsionnykh
  4. vmeshatel'stv. Mezhdunarodnyi zhurnal interventsionnoi
  5. kardioangiologii[The ulnar arterial access: a forced alternative
  6. to radial access or a standalone operative access for percutaneous
  7. interventions. International journal of interventional
  8. cardioangiology]. 2013; 35: 21-24 (in Russ.).
  9. Gromov D.G., Sit'ko I.G., Ishevskii A.G., Arful' F.D.,
  10. Khairutdinov E.R. Bedrennyi i luchevoi varianty sosudistogo
  11. dostupa v endovaskuliarnykh diagnostike i lechenii OKS u
  12. bol'nykh pozhilogo vozrasta: sravnitel'nyi analiz blizhaishikh
  13. kliniko-angiograficheskikh rezul'tatov. Mezhdunarodnyi zhurnal
  14. interventsionnoi kardioangiologii[Femoral and ray vascular
  15. access options in endovascular diagnosis and treatment of ACS
  16. in elderly patients: comparative analysis of immediate clinical
  17. and angiographic results. International journal of interventional
  18. cardioangiology]. 2013; 35: 39-42 (in Russ.).
  19. Goloshchapov–Aksenov R.S., Sitanov A.S. Luchevoi arterial'nyi
  20. dostup – prioritetnyi dostup dlia vypolneniia chreskozhnoi
  21. koronarnoi angioplastiki u bol'nykh s ostrym koronarnym
  22. sindromom. Mezhdunarodnyi zhurnal interventsionnoi
  23. kardioangiologii[Ray arterial access - priority access for
  24. percutaneous coronary angioplasty in patients with acute coronary
  25. syndrome. International journal of interventional cardioangiology].
  26. ; 35: 37-44 (in Russ.).
  27. Gorodetskii V.M., Gorelov V.M., Iosad V.G. Intensivnaia terapiia
  28. kriticheskikh sostoianii v gematologicheskoi klinike[Intensive
  29. therapy of critical conditions in the hematological clinic]. Ter.
  30. arkh. 1988; 60: 5: 118-124 (in Russ.).
  31. Bychinin M.V., Galstian E.M., Shulutko S.M., Kulikov G.M.
  32. Kateterizatsiia arterii u bol'nykh s gemorragicheskim sindromom.
  33. Anesteziologiia i reanimatologiia[Catheterization of arteries
  34. in patients with hemorrhagic syndrome. Anesthesiology and
  35. intensive care]. 2014; 2: 64-69 (in Russ.).
  36. Bychinin M.V., Galstian E.M., Shulutko S.M., Kliasova G.A.,
  37. Gorodetskii V.M. Kateterizatsiia arterii u bol'nykh s patologiei
  38. sistemy krovi. Gematologiia i transfuziologiia[Catheterization of
  39. arteries in patients with blood system pathology. Hematology and
  40. Transfusiology]. 2013; 58: 1: 14-22 (in Russ.).
  41. Andreev A.V., Zabolotskikh I.B., Shepelev A.A., Lovpache S.Z.,
  42. Leveshko A.I., Nikol'skaia N.A., Vasil'ev A.I. Kateterizatsiia
  43. magistral'nykh sosudov pod ul'trazvukovym kontrolem. Vestnik
  44. MUZ GB No 2[Catheterization of great vessels under ultrasound
  45. test. Herald of the MHCI EH No. 2]. 2013; 3 (27): 21-26 (in Russ.).
  46. Kireev K.A., Abaidulin R.Zh., Fokin A.A., Kireeva T.S.
  47. Klinicheskoe nabliudenie gemorragicheskogo i tromboticheskogo
  48. oslozhneniia posle chreskozhnogo koronarnogo vmeshatel'stva
  49. pri infarkte miokarda. Diagnosticheskaia i interventsionnaia
  50. radiologiia[Clinical observation of hemorrhagic and thrombotic
  51. complications after percutaneous coronary intervention in cardiac
  52. infarction. Diagnostic and interventional radiology]. 2015; 9: 2-1:
  53. -78 (in Russ.).
  54. Atanesian R.V., Matchin Iu.G., Shamrina N.S., Balakhonova
  55. T.V. Opyt primeneniia loktevoi arterii v kachestve operativnogo
  56. dostupa dlia provedeniia interventsionnykh vmeshatel'stv na
  57. koronarnykh arteriiakh. Kardiologicheskii vestnik[The experience
  58. of using the ulnar artery as an operational access for percutaneous
  59. coronary artery interventions. Herald of cardiology]. 2015; 10: 2:
  60. -29 (in Russ.).
  61. Volkov S.V., Udovichenko A.E., Mostovoi I.V., Bagin S.A.,
  62. Korobkov A.O. Opyt primeneniia ushivaiushchikh ustroistv
  63. posle endovaskuliarnykh vmeshatel'stv. Angiologiia i
  64. sosudistaia khirurgiia. Materialy XXVIII Mezhdunarodnoi
  65. konferentsii Rossiiskogo obshchestva angiologov i sosudistykh
  66. khirurgov[Experience of application suturing devices after
  67. endovascular interventions. Angiology and vascular surgery.
  68. Records of XXVIII International conference of the Russian
  69. society of angiologists and vascular surgeons]. 2013; 19: 2: 60–61
  70. (in Russ.).
  71. Popugaev K.A., Savin I.A., Oshorov A.V., Arustamian S.R.,
  72. Iakovlev S.B., Lubnin A.Iu. Oslozhnenie invazivnogo monitoringa
  73. gemodinamiki: obrazovanie obshirnoi gematomy bedra.
  74. Anesteziologiia i reanimatologiia[Complications of invasive
  75. hemodynamic monitoring: formation of thigh big hematoma.
  76. Anesthesiology and intensive care]. 2009; 3: 64-66 (in Russ.).
  77. Sukhov V.K., Shloido E.A., Shubenok D.A., Kravchenko
  78. K.P., Sergeev A.S., Igoshin S.D. Oslozhneniia transkateternoi
  79. implantatsii aortal'nogo klapan. Aktual'nye voprosy
  80. interventsionnoi radiologii. Mezhdistsiplinarnyi podkhod k
  81. lecheniiu[Complications of transcatheter implantation of the aortic
  82. valve. Current issues of interventional radiology. Interdisciplinary
  83. approach to treatment]. 23-24 oktiabria 2015 g. Sankt-Peterburg
  84. ; 24-25 (in Russ.).
  85. Matchin Iu.G., Atanesian R.V., Basinkevich A.B., Shamrina N.S.,
  86. Balakhonova T.V., Shiriaev A.A. Pervye rezul'taty primeneniia
  87. novoi metodiki – loktevogo arterial'nogo dostupa – dlia provedeniia
  88. diagnosticheskoi koronarografii i endovaskuliarnogo lecheniia
  89. koronarnykh arterii. Diagnosticheskaia i interventsionnaia
  90. radiologiia[First results of a new technique – ulnar arterial access
  91. for diagnostic coronary angiography and endovascular treatment
  92. of coronary arteries. Diagnostic and interventional radiology].
  93. ; 6: 2: 67–78 (in Russ.).
  94. Tyryshkin A.G., Paniukov A.V., Chaika Iu.G., Zhidkov S.V.,
  95. Podkovyrkin V.V., Gubarenko E.Iu., Ushakova T.N. Pervyi
  96. opyt altaiskogo kraevogo kardiologicheskogo dispansera po
  97. primeneniiu ustroistv dlia zakrytiia bedrennogo punktsionnogo
  98. dostupa pri rentgenokhirurgicheskikh vmeshatel'stvakh.
  99. Mezhdunarodnyi zhurnal interventsionnoi kardioangiologii[The
  100. first Altay regional cardiologic dispensary experience of
  101. application of the device made for closing femoral puncture
  102. access for endovascular interventions. International journal of
  103. interventional cardioangiology]. 2013; 32: 33–36 (in Russ.).
  104. Matchin Iu.G., Dragnev A.G., Balakhonova T.V.,. Belenkov
  105. Iu.N. Pervyi opyt primeneniia klipiruiushchego ustroistva dlia
  106. zakrytiia arterial'nogo dostupa posle endovaskuliarnogo lecheniia
  107. koronarnykh arterii. Kardiologiia[The first experience of using
  108. clipimage device for closure of arterial access after coronary
  109. arteries endovascular treatment. Cardiology]. 2008; 48: 1: 15-18
  110. (in Russ.).
  111. Fettser D.V., Batyraliev T.A., Pershukov I.V., Preobrazhenskii
  112. D.V., Kochak A., Sidorenko B.A. Prediktory vyrazhennykh
  113. krovotechenii iz bedrennoi arterii pri chreskozhnykh koronarnykh
  114. vmeshatel'stva. Mezhdunarodnyi zhurnal interventsionnoi
  115. kardioangiologii[Predictors of severe bleeding from the femoral
  116. artery during percutaneous coronary intervention. International
  117. journal of interventional cardioangiology]. 2009; 19: 71–72 (in
  118. Russ.).
  119. Ivanov V.A., Terekhin S.A., Bobkov Iu.A., Trunin I.V., Movsesiants
  120. M.Iu., Smirnov V.L., Ivanov A.V., Vitiazev S.P., Maiskov V.V.
  121. Primenenie ustroistv dlia zakrytiia bedrennogo punktsionnogo
  122. dostupa pri rentgenokhirurgicheskikh vmeshatel'stvakh.
  123. Mezhdunarodnyi zhurnal interventsionnoi kardioangiologii[Use
  124. of devices for the closure of femoral puncture access for
  125. endovascular interventions. International journal of interventional
  126. cardioangiology]. 2008; 14: 40a-40b (in Russ.).
  127. Shulutko E.M., Bulanova E.L., Gorodetskii V.M., Galstian
  128. G.M., Budianskii V.M. Problema sosudistogo dostupa v
  129. gematologicheskoi klinike. Problemy gematologii i perelivaniia
  130. krovi[The problem of vascular access in the hematological clinic.
  131. Problems of hematology and blood transfusion]. 1995; 2:26-28 (in
  132. Russ.).
  133. Abugov S.A., Puretskii M.V., Saakian Iu.M., Poliakov R.S., Pirkova
  134. A.A., Privalova E.A. Rezul'taty primeneniia klipiruiushchei
  135. sistemy dlia gemostaza posle koronarografii. Kardiologiia i
  136. serdechno-sosudistaia khirurgiia[The results of kiperousa system
  137. application for hemostasis after coronary angiography. Cardiology
  138. and cardiovascular surgery]. 2011; 4:3: 35-38 (in Russ.).
  139. Gubenko I.M., Analeev A.I., Semitko S.P., Klimov V.P., Maiskov
  140. V.V., Azarov A.V., Ioseliani D.G. Sravnitel'nye rezul'taty
  141. ispol'zovaniia razlichnykh ustroistv dlia gemostaza u bol'nykh
  142. posle chreskozhnykh endovaskuliarnykh vmeshatel'stv,
  143. vypolnennykh transfemoral'nym dostupom. Mezhdunarodnyi
  144. zhurnal interventsionnoi kardioangiologii[Comparative results of
  145. using different devices for hemostasis in patients after percutaneous
  146. endovascular interventions performed by transfemoral access.
  147. International journal of interventional cardioangiology]. 2013; 35:
  148. -42 (in Russ.).
  149. Bykov M.V., Saratovskii A.S., Bagaev V.G., Amcheslavskii
  150. V.G., Lazarev V.V. UZI v obespechenii bezopasnoi kateterizatsii
  151. bedrennoi veny. Meditsinskii alfavit[Ultrasound in the provision
  152. of safe catheterization of the femoral vein. Medical alphabet].
  153. ; 1: 5: 56-57 (in Russ.).
  154. Chazov E.I. Endovaskuliarnoe deponirovanie immobilizovannogo
  155. tromba s tsel'iu ostanovki krovotecheniia. Nauchnye trudy
  156. Irkutskogo medinstituta[Endovascular deposition of immobilized
  157. thrombus to stop bleeding. Scientific proceedings of the Irkutsk
  158. medical Institute]. 1981; 152: 45-47 (in Russ.).
  159. Belov Iu.V., Abugov S.A., Puretskii M.V., Saakian Iu.M., Poliakov
  160. R.S., Pirkova A.A., Privalova E.A. Effektivnost' primeneniia
  161. klipiruiushchei sistemy Starclose u patsientov s ishemicheskoi
  162. bolezn'iu serdtsa, podvergaiushchikhsia koronarnoi angioplastike
  163. i stentirovaniiu, nakhodiashchikhsia na antiagregantnoi i
  164. antikoaguliantnoi terapii. Kardiologiia i serdechno-sosudistaia
  165. khirurgiia[The effectiveness of using kiperousa system Starclose
  166. in patients with ischemic heart disease which undergo coronary
  167. appropriateness of including bleeding as a component of a
  168. quadruple end point. J. Am. Coll. Cardiol. 2008; 51: 690-698.
  169. Krueger K., Zaehringer M., Strohe D. et al. Post catheterization
  170. pseudoaneurysm: results of US-guided percutaneous thrombin
  171. injection in 240 patients. Radiology. 2005; 236: 1104-1112.
  172. Dudeck O., Teichgraeber U., Podrabsky P., Haenninen E.L.,
  173. Soerensen R., Ficke J.A. Randomized trial assessing the value of
  174. ultrasound-guided puncture of the femoral artery for interventional
  175. investigations. Int. J. Cardiovasc. Imag. 2004; 20: 363-368.
  176. Moscucci M., Share D., Smith D.et al. Relationship between
  177. operator volume and adverse outcome in contemporary
  178. percutaneous coronary intervention practice: an analysis of a
  179. quality-controlled multicenter percutaneous coronary intervention
  180. clinical database. J. Am. Coll. Cardiol. 2005; 46: 625-634.
  181. Schwartz B.G., Burstein S., Economides C., Kloner R.A., Shavelle
  182. D.M., Mayeda G.S. Review of vascular closure devices. J. Invasive
  183. Cardiol. 2010; 22 (12): 599–607.
  184. Spiliopoulos S., Katsanos K., Karnabatidis D., Diamantopoulos
  185. A., Nikolaos C., Siablis D. Safety and efficacy of the StarClose
  186. vascular closure device in more than 1000 consecutive peripheral
  187. angioplasty procedures. J. EndovascTher. 2011; 18(3): 435-443.
  188. Scheer B.V., Perel A., Pfeiffer U.J. Clinical review: complications
  189. and risk factors of peripheral arterial catheters used for
  190. haemodynamic monitoring in anaesthesia and intensive care
  191. medicine. Crit Care. 2002; 6: 199-204.
  192. Seldinger S.I. Catheter replacement of the needle in percutaneous
  193. arteriography; a new technique. Acta radiol. 1953; 39(5): 368-376.
  194. Baim D.S., Knopf W.D., Hinohara T. et al Suture-mediated closure
  195. of the femoral access site after cardiac catheterization: results of
  196. the suture to ambulate and discharge (STAND I and STAND II)
  197. trials. Am. J. Cardiol. 2000; 85: 864-871.
  198. Kapadia S.R., Raymond R., Knopf W.et al. The 6Fr Angio-Seal
  199. arterial closure device: results from a multimember prospective
  200. registry. Am. J. Cardiol. 2001; 87: 789-794.
  201. Chiu A.H., Coles S.R., Tibballs J., Nadkarni S. The StarClose
  202. vascular closure device in antegrade and retrograde punctures: a
  203. single-center experience J. EndovascTher. 2010; 17(1): 46–50.
  204. Abando A., Hood D., Weaver F., Katz S. The use of the Angioseal
  205. device for femoral artery closure. J. Vasc. Surg. 2004; 40: 287–290.
  206. Tiru B., Bloomstone J.A., McGee W.T., Tiru B. Radial Artery
  207. Cannulation: A Review Article. J. Anesth. Clin. Res. 2012; 3
  208. doi: 10.4172/2155-6148.1000209.
  209. Popma J.J., Satler L.F., Pichard A.D. et al.Vascular complications
  210. after balloon and new device angioplasty. Circulation. 1993; 88:
  211. -1673.
  212. Nikolsky E., Mehran R., Halkin A. et al. Vascular complications
  213. associated with arteriotomy closure devices in patients undergoing
  214. percutaneous coronary procedures: a meta-analysis. J. Am. Coll.
  215. Cardiol. 2004; 44: 1200-1208.
  216. Vento S., Cainelli F., Vento S. Infections in patients with cancer
  217. undergoing chemotherapy: aetiology, prevention, and treatment.
  218. Lancet Oncol. 2003; 4(10): 595-604.
  219. Vetrugno L., Muzzi R., Giordano F., Vetrugno L. Pectoral
  220. Muscle hematoma after Axillary Artery Catheterization in
  221. Patient Undergoing Minimal Invasive Mitral Valve Surgery. J.
  222. Cardiothorac. Vasc. Anesth. 2007; 21(1): 96-98.
  223. Hannan E.L., Wu C., Walford G. et al. Volume-outcome
  224. relationships for percutaneous coronary interventions in the stent
  225. erа. Circulation. 2005; 112: 1171-1179.
  226. Warren B.S., Warren S.G., Miller S.D., Warren B.S. Predictors of
  227. complications and learning curve using the Angio-Seal closure
  228. device following interventional and diagnostic catheterization.
  229. Catheter Cardiovasc. Interv. 1999; 48: 162–166

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