New Way to Stitch Up Arteries
Simpler, safer method closes punctures after angioplasty, stenting
WEDNESDAY, March 3, 2004 (HealthDayNews) -- A new device called X-Press gives cardiologists a simpler, safer method of stitching up arterial punctures after such catheter-based coronary procedures as angioplasty and stenting, says an American study.
Eight U.S. medical centers evaluated this new stitching device, which is not yet commercially available in the United States. The study appears in the March issue of Catheterization and Cardiovascular Interventions: Journal of the Society for Cardiovascular Angiography and Interventions.
"We're actually seeing a reduction in complications. This is the first suture device to demonstrate that," study leader Dr. Timothy A. Sanborn, cardiology head at Evanston Northwestern Healthcare in Illinois, says in a prepared statement.
During catheter-based coronary procedures, doctors need to puncture a large artery, usually in the groin, to insert the catheter and thread it through the body and into the heart arteries. Once the procedure is completed, the puncture must be closed to prevent excessive bleeding.
The conventional method is to apply firm pressure to the puncture wound for 20 to 30 minutes after the catheter is removed. This lets a blood clot form and seal the artery. The patient must then lie in bed for six to eight hours so that the blood clot isn't dislodged.
The X-Press device is inserted into the artery puncture wound. It guides the cardiologist as he or she passes stitching needles through the skin and into the artery, above and below the catheter puncture site. As it's pulled from the body, the X-Press pulls the leading end of each stitching thread out with it, creating a loop. The cardiologist ties these threads into a knot, cinching the threads together and closing the puncture in the artery.
The study included 400 patients. It found those who had diagnostic cardiac catheterization to diagnose heart disease and were treated with the X-Press device were able to get out of bed and walk around after an average of 2.2 hours, compared to an average of 6.2 hours for patients treated with manual wound pressure.
The difference was greater among patients who had percutaneous coronary intervention (PCI) to treat clogged heart arteries. Among these patients, those treated with X-Press were able to get out of bed and walk around within an average of four hours, compared to nearly 15 hours for patients treated with manual wound pressure.
The U.S. National Library of Medicine has more about cardiac catheterization.