Efficacy And Safety Of Figure-Of-Eight Suture For Hemostasis After Catheter Ablation Via Femoral Vein Approach

Background:some common arrhythmia patients in clinic need interventional therapy through femoral vein approach catheter ablation.However,after the completion of ablation,it often faces the risk of bleeding and vascular complications.The incidence of vascular access complications is about 50.2-1.5 %.At present,the traditional hemostasis scheme in China is mainly manual hemostasis + bandaging;figure-of-Eight Suture(Figure-of-Eight Suture)is a new method of hemostasis.Studies have shown that compared with manual compression,the hemostatic effect of Figure-of-Eight Suture is significantly faster than that of manual compression.Secondly,it can reduce the occurrence of venous access-related complications,so as to provide patients with better comfort and experience.However,there are still some centers that have some doubts about the hemostatic effect of simple ’ 8’suture,so some centers even adopt the hemostatic method of ’ 8’suture combined with manual bandage compression bandage.This method may potentially reduce the incidence of local hematoma and other bleeding events,but may increase the pain of patients and the risk of related thrombotic events to a certain extent.At present,there is no relevant research literature at home and abroad on the safety and effectiveness of this hemostatic method.In addition,the above literature reports focus on the safety and effectiveness,and there is still a lack of relevant research reports on the comfort of various hemostatic methods,that is,the pain and perception of patients.Objective:In this study,we compared the hemostatic effect,comfort and the incidence of vascular access complications of three different hemostatic methods(simple ’ 8 ’suture,manual compression + bandage compression bandage and ’ 8 ’ suture +bandage compression bandage)in patients undergoing catheter ablation through femoral vein approach,so as to evaluate the advantages and disadvantages of different hemostatic methods,so as to find a way to ensure the postoperative hemostatic effect,without increasing the incidence of adverse reactions,improve the patient ’s comfort and experience,and provide more evidence-based basis for the management of hemostasis after catheter ablation.Methods:According to the inclusion and exclusion criteria,164 patients who underwent catheter ablation via femoral vein approach from July 2021 to November 2021 to the Second Affiliated Hospital of Nanchang University were randomly divided into group A(simple ’ 8 ’ suture group),group R(’ 8 ’ suture + bandage compression bandage group)and group C(hand compression + bandage compression bandage group)by single blind method according to the sequence given by random number table.The same amount of heparin was used during the operation,and no protamine sulfate reverse heparin was used after the operation.The patient ’s age,gender,blood pressure,heart rate,body mass index,liver and kidney function,coagulation function,complications(hypertension,cerebral infarction,etc.),and surgical disease types(atrial fibrillation,atrial flutter,paroxysmal supraventricular tachycardia,frequent ventricular premature beats,etc.)were collected before surgery.In addition,for patients with atrial fibrillation,data on whether patients use antiplatelet and anticoagulant drugs were also collected.The surgeon ’s satisfaction with the hemostatic effect was asked immediately after the operation.On the night of the end of the operation,the Wong-Baker pain assessment scale was used to assess the degree of discomfort felt by the patient after the operation and to describe the nature and location of the pain.Results:In the comparison of patients ’ pain score and comfort score,there were significant differences among the three groups(P < 0.001),and the differences were mainly reflected in the significant differences between group A and the other two groups.However,there was no significant difference in the degree of pain and comfort score between group C and group R(P = 0.614 and 0.556,respectively),suggesting that the pain degree of group A was significantly lower than that of group C and group R,and the comfort degree was significantly improved.In the comparison of postoperative complications among the three groups,there were statistically significant differences in congestion area,sleep disorder and hematoma(P < 0.01).Among them,group A and group R were better than group C,while there was no significant difference between group A and group R,indicating that the incidence of related complications in group A and group R was lower than that in group C.Compared with the expected pain value,there was a significant difference between the three groups(P < 0.001).In general,patients in group A had lighter selfperception than preoperative expectations,but group C and group R had the opposite.In terms of the performance of the pain site,group A was significantly different from the other two groups,because group A was only sutured,so its pain was only reflected in the puncture site,while the patients who underwent traditional compression + bandage or suture + bandage mainly had obvious pain in the bandage site.There was no significant difference in hospitalization days among the three groups(P = 0.107).In the comparison of the general characteristics of patients before surgery,except for differences in blood glucose(P < 0.05)and history of cerebral infarction,there were no statistical differences in other related indicators(age,gender,BMI,liver and kidney function,coagulation function,heart rate,blood pressure,blood lipids,disease type,type of surgery,use of anticoagulants,whether or not combined with hypertensive cerebral infarction).Conclusion:The application of 8-shaped suture technique after femoral vein catheter ablation can effectively reduce the postoperative pain symptoms of patients,provide good comfort,reduce the occurrence of postoperative complications related to venous access,improve the postoperative experience of patients,and reduce the time of medical staff in postoperative nursing.