Closure of the femoral vein puncture site after transcatheter procedures using Angio‐Seal

Abstract

The use of anchor-based, collagen-derived vascular sealing devices in femoral vein punctures during right and left heart catheterizations or coronary interventions necessitating venous access for temporary pacemaker or hemodynamic monitoring has not been studied. We hypothesized that using these devices in the femoral vein would be practical and reliable. One hundred and ten consecutive patients undergoing right and left heart catheterization (56 patients, 51%) or coronary intervention (54 patients, 49%) were included in this study. Forty-five of the interventions received IIb/IIIa inhibitors in combination with heparin, enoxaparin, aspirin, and clopidogrel. The Angio-Seal device was successfully deployed in the femoral vein in all patients, whereas 93 (85%) received arterial Angio-Seal, 8 received Perclose, and 9 (8%) had manual pressure or a Fem-Stop applied to control arterial bleeding after deployment. We conclude that in patients undergoing transcatheter procedures requiring venous access, the use of an 8 Fr Angio-Seal to seal the femoral vein is safe and feasible.

Use of suture‐mediated vascular closure devices for the management of femoral vein access after transcatheter procedures

“…Since then, there have been no additional infections. There has been one report of using the AngioSeal, an anchor-based vascular sealing device that is collagen-mediated, in the removal of femoral venous sheaths [7]. In this report, there were no complications in the 110 patients who underwent the procedure, with the AngioSeal deployed successfully in all patients and no venous ooze noted.…”

Pre-closure of femoral venous access sites used for large-sized sheath insertion with the Perclose device in adults undergoing cardiac intervention

“…There are two previously reported series on the use of closure devices in venous sites,3 4 one of which used an earlier version of the Perclose device4 in which the majority had 7Fr sheaths. In contrast to previous studies3 4 the devices were predeployed in this study.…”

“…In contrast to previous studies3 4 the devices were predeployed in this study. This study demonstrates, using the pre-closure technique, safe and efficacious closure of the femoral venous access site can be performed in the presence of anticoagulants with a suture-mediated device irrespective of eventual sheath size (up to 14Fr) and two devices can be used at two different access sites in the same vein.…”

Venous hemostasis postcatheter ablation of atrial fibrillation while under therapeutic levels of oral and intravenous anticoagulation

“…The use of the Perclose (Abbott Vascular Devices, Redwood City, CA) suture-mediated device for femoral vein access site closure following large (>8 Fr) sheath insertion was associated with a 98 % success rate of immediate (within 2 min) hemostasis in a wide range of congenital and structural cardiac interventions [16][17][18][19]. In one report, the Angio-Seal (St. Jude Medical, Minnetonka, MN) collagen-mediated, anchor-based vascular sealing device was found safe and successful for femoral venous hemostasis (in patients with venous sheaths ≤8 Fr), with no major complications, even in the presence of anticoagulation and antiplatelet agents [20]. Compared to those devices, the F-8 suture technique is simple, easy to perform, less expensive, and does not require the learning curve experienced with the closure devices.…”