Читать книгу Interventional Cardiology - Группа авторов - Страница 56

The AngioSeal device consists of a rectangular absorbable copolymeric anchor deployed intravascularly against the arterial wall which is attached by an absorbable Dexon traction suture to an extravascular collagen plug applied to the outside of the arterial wall. The AngioSeal assembly consists of a carrier system with the anchor, collagen plug, and traction suture compacted at the distal end. There is a delivery sheath with a modified locator dilator which identifies when the sheath is intravascular. After cardiac catheterization, the working sheath is changed over to the AngioSeal delivery sheath. Once the delivery sheath is intravascular, as indicated by pulsatile flow in the arteriotomy locator system of the dilator, the dilator and wire are removed. The carrier is then advanced into the sheath, locks in place with the sheath, and then the entire assembly is withdrawn until resistance is felt. This indicates apposition of the anchor on the luminal arterial wall. Further withdrawal releases the collagen plug on the external surface of the artery, followed by a tamper tube. The tamper tube is used to compress the plug over the wire, followed by removal of the tamper tube and cutting of the suture, which are external to the patient. Currently, the AngioSeal is available in two sizes: 6 and 8 Fr. Deployment success rates ranged from 92% to 98%, and hemostasis success ranged from 84% to 97% [26].