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At least 19 recordsLinked to original sources

Assessment of the safety and efficacy of the DUETT vascular hemostasis device: final results of the safe and effective vascular hemostasis (SEAL) trial.

OBJECTIVE: We sought to determine the safety and efficacy of the novel DUETT vascular hemostasis device in comparison with standard manual compression after diagnostic and interventional coronary procedures. BACKGROUND: Vascular hemostasis devices are increasingly used to improve patient comfort and speed mobilization after coronary and peripheral vascular procedures. Currently available devices have certain limitations, however. METHODS: At 16 clinical sites, 630 patients who underwent diagnostic or interventional coronary procedures were randomized 5:3 to the DUETT sealing device or standard manual compression. The primary study end points were time to hemostasis and ambulation and the incidence of major vascular complications at 30 days. RESULTS: Time to hemostasis from the completion of the procedure (catheter removal; median) was 14 minutes (interquartile range [IQR], 10, 17 minutes) in the DUETT group and 195 minutes (IQR, 46, 351 minutes) in the standard compression group (P <.001), and time from sheath removal (median) was 7 minutes (IQR, 6, 8 minutes) and 20 minutes (IQR, 15, 30 minutes) for the 2 groups, respectively (P <.001). Time to ambulation from catheter removal (median) was 338 minutes (IQR, 223, 526 minutes) in the DUETT group and 705 minutes (IQR, 400, 1120 minutes) in the standard compression group (P <.001). Major complications occurred in 3.6% of the DUETT group and 1.7% of the standard compression group (P =.22), with a diminishing risk of complications in the DUETT group as experience was accrued. Similar benefits from DUETT use were seen in patients who underwent both diagnostic and interventional procedures. CONCLUSION: The DUETT sealing device allows immediate arterial sheath removal after both diagnostic and interventional procedures, dramatically reducing time to hemostasis and patient ambulation without compromising patient safety in comparison with standard compression techniques.

Adult↗

Does recombinant factor VIIa, apart from overall hemostasis, regulate TAFI dependent fibrinolysis? In vitro analysis using overall hemostasis potential (OHP) assay.

Using the recently developed overall hemostatic potential (OHP) assay, we investigated the effects of different concentrations of recombinant factor VIIa on overall hemostasis and on thrombin activatable fibrinolysis inhibitor (TAFI) dependent fibrinolysis in different factor deficient plasmas. rFVIIa increased OHP in FV, FVIII and FIX deficient plasmas but not up to the levels in normal pooled plasma (NPP). Maximal levels were found at 2.4 microg/mL of rFVIIa, while higher doses did not further increase OHP. In FXII deficient plasma, OHP is higher than in NPP and addition of rVIIa further increased it. Even very high concentrations of rFVIIa (9.6 microg/mL) did not induce a significant increase of OHP in NPP. Higher concentrations of rVIIa down-regulated fibrinolysis in FVIII, FIX and FXI deficient plasmas to values obtained in NPP. Using potato tuber carboxy-peptidase inhibitor (PTCI), a specific inhibitor of TAFI, it was found that TAFI's influence on fibrinolysis down-regulation in FVIII and FIX deficient plasmas increased after addition of higher concentrations of rFVIIa. From this in vitro study it seems that rFVIIa in a concentration of 2.4 microg/mL improves overall hemostasis in FV, FVIII and FIX deficient plasmas. rFVIIa, even at very high (supra-therapeutic) concentrations, does not induce hypercoagulability either in NPP or in deficient plasmas. Higher concentrations of rVIIa induce, at least partly, TAFI dependent down-regulation of fibrinolysis in FVIII and FIX deficient plasmas. These results, together with some previous ex vivo studies, point to OHP assay as a possible diagnostic tool for evaluating the hemostatic effects of rFVIIa.

Blood Coagulation Tests↗

[Hemostasis in patients operated for abdominal bleeding. I. Estimation of the relationship of hemostasis parameters according to data of the correlation coefficient and factor analysis].

The work was aimed to estimate the interrelation and indexes which define the main alterations of hemostatic deviations in the patients with abdominal bleeding. For this reason the authors have analysed interrelations between 31 hemostasis indexes in 30 patients after operations. Fourteen groups of interrelated indications have been revealed. They are as follows: 1. Prothrombin index, activated partial thromboplastin index; 2. Prothrombin's inactive forms (prethrombin-1, decarboxylated prethrombin etc.), ecamulin index; 3. Velocity bend of distraction of fibrin clot, velocity bend of forming of fibrin clot, height of clot using turbidimetric method; 4. Half-lysis time, lysis time, time of fibrin clot using turbidimetric method; 5. Velocity, Intensity, remainder of platelet aggregation induced by ADP 10 mcg/ml, 2.5 mcg/ml, 1.9 mcg/ml; 6. Thrombin time; 7. Protein C; 8. Fibrinogen; 9. Platelet count; 10. Soluble fibrin; 11. Ancystron time; 12. X factor; 13. Antithrombin-III; 14. Fibrin(ogen) degradation products. It was shown how different groups affect hemostasis. The authors have suggested to use the data of mathematical analysis and laboratory tests for the estimation of hemostatic deviations.

Abdomen↗

[A study on endoscopic hemostasis from the viewpoint of morphologic traits of Dieulafoy ulcer--an attempt at endoscopic hemostasis by local injection of aethoxysklerol and ethanol].

Characteristics of the vascular course of ruptured vessels in the submucosal layer of Dieulafoy ulcer were studied, and endoscopic hemostatic treatment was performed using Aethoxysklerol and ethanol. 1) Observations of vessel courses in serial sections revealed that ruptured vessels in Dieulafoy ulcer exhibit rhexis in the lateral portions of the vessel and long courses over the ulcer margin in the submucous layer. 2) More dependable hemostasis seemed to be provided by thrombosis not only at the source of bleeding. i.e., at the site of vessel rupture, but also in the region of the whole ruptured vessel in the submucous layer. 3) Hemostatic treatment by local injection of Aethoxysklerol and ethanol was performed in 4 patients with Dieulafoy ulcer, and complete hemostasis was achieved in all 4 patients.

Adult↗

[Legal abortion and hemostasis. Histological examinations and comparison to post partum hemostasis (author's transl)].

30 women were examined to determine the hemostasis during the legally induced abortion. The blood coagulated in the intervillous spaces while the fetus is removed. Immediately after the termination of the curettment the nidation area is covered by filaments of fibrin and incorporated erythrocytes. More frequent as post partum platelet thrombi occur especially in the area of decidua parietalis. The intravascular findings are similar to post partum changes after the removal of the placenta. Obstruction clots of the spiral arterioles contain fibrin deposits, pletelet thrombi and erythrocytes (mixed form of thrombi). Residual decidua and trophoblast cells are seldom involved in the obturation of the vessels. The traumatic damages of the uterine wall are described (extravascular fibrin deposits, interstitial bleeding, succulent tissue a.s.o.).

Abortion, Legal↗

Hemostasis and menstruation: appropriate investigation for underlying disorders of hemostasis in women with excessive menstrual bleeding.

The evaluation of excessive menstrual bleeding carries a relatively high yield of discovering an underlying disorder of hemostasis in females. This review highlights important components in a structured history and outlines primary and secondary hematologic testing that should be considered in the evaluation of excessive menstrual bleeding.

Blood Coagulation Disorders↗