Peer-reviewed veterinary case report
Best ways to stop bleeding after dog vein procedures
By Fabella, A et al.·Published in Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology·2024·Department of Small Animal Medicine and Surgery, United States·View original on PubMed →
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Original publication title: Comparison of manual compression, Z-stitch, and suture-mediated vascular closure device techniques in dogs undergoing percutaneous transvenous intervention.
- Species:
- dog
Plain-English summary
A group of 46 dogs undergoing a procedure to access their veins had different methods tested to stop bleeding afterward. The Z-stitch method worked the fastest, stopping bleeding in about 2 minutes, while the manual compression method took around 10 minutes. The vascular closure device (VCD) was also quicker than manual compression but slower than the Z-stitch. All methods were effective in keeping the veins open without major complications. The Z-stitch method is recommended for quicker recovery after such procedures.
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Abstract
INTRODUCTION/OBJECTIVES: Manual compression has been standard of care for maintaining hemostasis after percutaneous endovascular intervention, but can be time-consuming and associated with vascular complications. Alternative closure methods include the figure-of-eight suture (Z-stitch) and vascular closure device (VCD) techniques. We hypothesized that compared to manual compression, Z-stitch and VCD would significantly reduce time-to-hemostasis after transvenous access, and the proportion of dogs with vascular patency would not differ significantly among treatments. ANIMALS: Forty-six client-owned dogs undergoing percutaneous transvenous interventional procedures. MATERIALS AND METHODS: Dogs with vessel diameter <5 mm were randomized to undergo manual compression or Z-stitch, while those with vessel diameter ≥5 mm were randomized to undergo manual compression, Z-stitch, or VCD. Time-to-hemostasis, bleeding scores, presence of vascular patency one day and two to three months post-procedure, and complications were recorded. Data are presented as median (95% confidence interval). RESULTS: In all 46 dogs, the right external jugular vein was used. Time-to-hemostasis was significantly shorter in the Z-stitch (2.1 [1.8-2.9] minutes) compared to VCD (8.6 [6.1-11.8] minutes; P<0.001) and manual compression (10.0 [10.0-20.0] minutes; P<0.001) groups. Time-to-hemostasis was significantly shorter in the VCD vs. manual compression (P=0.027) group. Bleeding scores were significantly greater at 5 and 10 min (P<0.001 and 0.013, respectively) in manual compression, compared to Z-stitch group. There was no difference in the proportion of dogs with vascular patency between groups (P=0.59). CONCLUSIONS: Z-stitch and VCD are effective venous hemostasis methods after percutaneous transvenous intervention, with Z-stitch providing the most rapid time-to-hemostasis. Both Z-stitch and VCD techniques have low complication rates and effectively maintain vascular patency.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38128418/