vascular is devices

8/3/2019 Vascular is Devices

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CREATED BY :

PRINSHA SANTOKI

05BM45(41)


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INTRODUCTION

Increasing rate of percutaneous coronary and

non-coronary interventions.

Millions of people worldwide undergo a femoral

artery catheterization, and other interventional

procedures, such as angiography, percutaneous

transluminal coronary angioplasty (PTCA), stenting

, atherectomy and catheter

ablation.

Due to this there is strong need to stop bleeding

at the puncture site without clotting in vessels as

quickly as possible.


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HEMOSTASIS

Physiologic process through which bleeding is

halted, thusprotecting the vascular system

integrity of the vascular system after tissue injury.

It is responsible for minimizing blood loss.

It is commonly referred to as stoppage of

bleeding;


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IMPORTANT FUNCTION OFHAEMOSTATIC

MECHANISMS :

Maintain blood in a fluid state while circulating.

Stop bleeding at the site of injury by formation of

haemostatic plug .

Removal of the haemostatic plug when healing iscomplete.


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Vasoconstriction :constricts the blood vessel,

minimizing vessel diameter and slowing bleeding.

Platelets adheration : Platelets bind to collagen

in the exposed walls of the blood vessel to form a

hemostatic plug .

Clotting : A complex cascade of coagulation factors,

resulting in the transformation of fibrinogen into fibrin

making a clot.

Fibrinolysis :The clot attracts and stimulates the

growth of fibroblasts within the vessel wall, and begins

the repair process which ultimately results in the

fibrinolysi i.e dissolution of the clot

STEPS OF ACHIEVING HEMOSTASIS :


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CONVENTIONALMETHODS :

In early days hand pressure, and/or sandbags wereused to stop bleeding following interventional cases.

A nurse or technician holds direct manual pressure

on the site until thrombus forms to seal the access

site.

DROWBACKS OF THESEMETHODS :

During these procedures patient must remain

immobilized .This is monotonous and tiresome task.

Due to this patients have to stay long in

hospital.


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HEMOSTASIS DEVICES :

TRICLIPS :

Used for initial hemostasis.

It is feasible in the initial control of peptic ulcer

hemorrhage.


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VASCULARHEMOSTASIS DEVICES :

FEMOSTOP :

Alternative to manual compression of the femoral

artery.

Inflatable transparent dome with connection tubing

and stopcock provides more accurate placement of

pressure.

Accurate manometercontrolled

pressure.

Less contact with blood.


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SUTUREMEDIATED CLOSUREDEVICE:

Provides secure reliableVessel closure .

Provides complete tissue

apposition resulting in primaryhealing .

Provides reduced time to Hemostasis,

ambulation and discharge.

No re-access restrictions if previous arteriotomy

repairs were achieved w/ Perclose Suture-Mediated

Closure devices


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Automated knot tying .

Reduced proceduretime.

Easy deployment .

Short sheath compatible

with long and short

wires.

Hydrophilic coated

straight tip sheath

facilitates insertion


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GUARDIAN HEMOSTASIS VALVE:

It is designed to minimize blood loss

during percutaneous procedures.

providing a seal around guidewires and otherdevices.

Its signature click-open, click-close design facilitates

single-handed operation.


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SAFEGUARD HEMOSTASIS DEVICE:

It is a single use adhesive dressing with a transparent

inflatable plastic bulb.When inflated the bulb is inelastic and provides

consistent pressure over the wound site to maintain

hemostasis.

This device proved effective at maintainin hemostasisfollowing femorally accessed coronary catheterization

procedures adhering to wound site reliably for hours

and producing no complication.


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RADIO-OPAQUEAGENT DELIVERY DEVICE:

It promotes the clotting of blood at an internal woundsite it includes a catheter; a delivery instrument

insertable through the catheter.

A radioopaque blood clotting agent that deliverablethroug the delivery instrument; and a positive

pressure apparatus that can dispense the blood

clotting agent to the wound site through the

delivery instrument.


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EPICLOSEHEMOSTATEDEVICE:

The EpiClose device is mostadvanced solution for femoral

artery closure.

The deployment methodology of the device relies onballoon inflation/deflation techniques that apply

selective pressure precisely over the puncture site,

with the addition of an energy application stage,

which accelerates hemostasis.

The Epiclose device can be introduced into the vessel

through most of the existing interventional- cardiology

introducer sheath


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It consists of three resorbable

components: an anchor,a collagen sponge and a

suture along with a delivery

system that closes the puncture.

The anchor and suture act as a pulley to position the

collagen into the puncture tract adjacent to the outside

of the artery wall to seal and close .

This easy to use device has been used to facilitate

post-procedure care in over five million patients since

its commercial launch in 1996.

ANGIO-SEAL DEVICE


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Following the catheterization

procedure, the Angio-Seal device isinserted into the femoral artery .

The Angio-Seal device is withdraw

until the anchor is seated in theartery puncture

PROCEDURE OF USING ANGIO-SEAL:


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Complete withdrawal of the device compresses the

collagen sponge in the puncture tract adjacent to the

outside of the artery wall to stop blood flow through

the puncture.

The anchor, collagen and suture are resorbed within

60-90 days after the procedure.


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ACCESS CLOUSER DEVICE:

This closure device immediately seals thearteriotomy using a conformable, water-soluble,

extravascular sealant that rapidly expands in the

tissue tract by absorbing blood and subcutaneous

fluids.As blood collects inside the sealant's matrix it clots,

producing a durable hemostasis.

The sealant dissolves within 30 days, leaving

nothing behind but a healed artery.


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The device can be stored at room temperature and

prepared in less than two minutes.

The VascuSeal sealant technology is a patented

synthetic,absorbable hydrogel delivered by a dual

syringe applicator.

VASCUSEAL :


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VascuSeal sealant polymerizes within seconds when

sprayed on the suture line and is blue in color which

provides visualization of coverage and thickness of

the material upon application.

Postoperatively, VascuSeal sealant continues to seal

the suture line as healing progresses under the gel.

After several days, the hydrogel breaks down into

water-solublemolecules that are absorbed and

cleared through the kidneys.


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It replace or augment manual compression following

diagnostic catheterizations.

Reduces time to hemostasis and facilitating more

rapid recovery.

External compression products, which include

chemically-treated patches, also simplify the process

of vascular closure for the clinician and staff.

Reduce time in the recovery room, which contributes

to better patient throughput and higher profits for

catheterization labs.

ADVANTAGES OFHEMOSTASIS DEVICES :


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DISADVANTAGES :

Complication related to infection and arterial thrombosis

Another drawback is compatibility problem of thesedevices

High coast.

Limited knowledge of its use.


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However VHD are improving, complication ratesassociated with their use may be decreasing, and

their utilization may improve the process of care after

femoral artery access.

Better understanding of the occurrence of adverse

events associated with the use of vascular hemostasis

devices following cardiac catheterization & furtherresearch on the subject to develop more ideal closure

devices will help to overcome these problems.

HOW TO GET BETTER RESULT ?


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