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Objectives <p>To evaluate the efficacy and safety of purse-string sutures (PSS) compared with manual compression for access hemostasis in children with atrial septal defects (ASDs) after large-caliber venous delivery sheaths removal.</p> Methods <p>We conducted a retrospective clinical data review of 271 children with ASDs who underwent transcatheter device closure through large-caliber venous delivery sheaths (≥ 8 Fr) at our institution from January 2018 to January 2023. The PSS group (<i>n</i> = 144) was compared to the control group (<i>n</i> = 127), which underwent manual compression for femoral venous hemostasis after sheath removal, focusing on hemostatic time, limb braking time, bed rest time, hospital stay, and vascular access complications. Two days post-catheterization, the sutures were taken out and a vascular ultrasound found the evidence of thrombosis, embolism, or venous narrowing.</p> Results <p>Compared to the control group, the PSS group had significantly shorter average hemostatic time (4.63 ± 1.95&#xa0;min vs. 19.69 ± 5.64&#xa0;min), limb braking time (6.83 ± 2.25&#xa0;h vs. 13.45 ± 2.87&#xa0;h), and bed rest time (8.69 ± 1.43&#xa0;h vs. 22.93 ± 2.24&#xa0;h) (all, <i>p</i> &lt; 0.001). There were no statistically significant differences in hospital stay and complications between the two groups.</p> Conclusions <p>The PSS is a simple, effective, and safe procedure that may play a valuable role in achieving rapid hemostasis after the removal of the large-caliber venous delivery sheaths in children. It allows earlier mobilization, reduces bed rest time, and alleviates discomfort compared to manual compression.</p>

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Purse string suture for rapid access hemostasis after removal of large-caliber femoral venous delivery sheaths in children with atrial septal defects

  • 期刊论文

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  • 发表日期：

    2025年1月15日

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  • Gang Luo,
  • Zhixian Ji,
  • Bei Zhang,
  • Yueyi Ren,
  • Silin Pan

摘要

Objectives

To evaluate the efficacy and safety of purse-string sutures (PSS) compared with manual compression for access hemostasis in children with atrial septal defects (ASDs) after large-caliber venous delivery sheaths removal.

Methods

We conducted a retrospective clinical data review of 271 children with ASDs who underwent transcatheter device closure through large-caliber venous delivery sheaths (≥ 8 Fr) at our institution from January 2018 to January 2023. The PSS group (n = 144) was compared to the control group (n = 127), which underwent manual compression for femoral venous hemostasis after sheath removal, focusing on hemostatic time, limb braking time, bed rest time, hospital stay, and vascular access complications. Two days post-catheterization, the sutures were taken out and a vascular ultrasound found the evidence of thrombosis, embolism, or venous narrowing.

Results

Compared to the control group, the PSS group had significantly shorter average hemostatic time (4.63 ± 1.95 min vs. 19.69 ± 5.64 min), limb braking time (6.83 ± 2.25 h vs. 13.45 ± 2.87 h), and bed rest time (8.69 ± 1.43 h vs. 22.93 ± 2.24 h) (all, p < 0.001). There were no statistically significant differences in hospital stay and complications between the two groups.

Conclusions

The PSS is a simple, effective, and safe procedure that may play a valuable role in achieving rapid hemostasis after the removal of the large-caliber venous delivery sheaths in children. It allows earlier mobilization, reduces bed rest time, and alleviates discomfort compared to manual compression.