Comparative outcomes of vascular access closure methods following atrial fibrillation/flutter catheter ablation: insights from VAscular Closure for Cardiac Ablation Registry

Mohammed, Moghniuddin; Ramirez, Rigoberto; Steinhaus, Daniel A.; Yousuf, Omair; Giocondo, Michael J; Ramza, Brian; Wimmer, Alan P.; Gupta, Sanjaya

doi:10.1007/s10840-021-00981-5

Cited by 18 publications

(23 citation statements)

References 19 publications

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“…After removing 462 duplicate studies, step by step screening was performed based on inclusion and exclusion criteria. Eventually, 32 studies comprising 12 RCTs [28][29][30][31][32][33][34][35][36][37][38][39], 17 observational studies [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55], and 3 propensity-score matched studies [56][57][58] were included in this meta-analysis. Figure 1 shows the flowchart of inclusions and exclusions.…”

Section: Search Resultsmentioning

confidence: 99%

Vascular Closure Devices versus Manual Compression in Cardiac Interventional Procedures: Systematic Review and Meta-Analysis

Pang

Gao

Zhang

et al. 2022

Cardiovascular Therapeutics

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Backgrounds. Manual compression (MC) and vascular closure device (VCD) are two methods of vascular access site hemostasis after cardiac interventional procedures. However, there is still controversial over the use of them and a lack of comprehensive and systematic meta-analysis on this issue. Methods. Original articles comparing VCD and MC in cardiac interventional procedures were searched in PubMed, EMbase, Cochrane Library, and Web of Science through April 2022. Efficacy, safety, patient satisfaction, and other parameters were assessed between two groups. Heterogeneity among studies was evaluated by I2 index and the Cochran Q test, respectively. Publication bias was assessed using the funnel plot and Egger’s test. Results. A total of 32 studies were included after screening with inclusion and exclusion criteria (33481 patients). This meta-analysis found that VCD resulted in shorter time to hemostasis, ambulation, and discharge ( p < 0.00001 ). In terms of vascular complication risks, VCD group might be associated with a lower risk of major complications ( p = 0.0001 ), but the analysis limited to randomized controlled trials did not support this result ( p = 0.68 ). There was no significant difference in total complication rates ( p = 0.08 ) and bleeding-related complication rates ( p = 0.05 ) between the two groups. Patient satisfaction was higher in VCD group ( p = 0.002 ). Meta-regression analysis revealed no specific covariate as an influencing factor for above results ( p > 0.05 ). Conclusions. Compared with MC, the use of VCDs significantly shortens the time of hemostasis and allows earlier ambulation and discharge, meanwhile without increase in vascular complications. In addition, use of VCDs achieves higher patient satisfaction and leads cost savings for patients and institutions.

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Section: Search Resultsmentioning

confidence: 99%

Vascular Closure Devices versus Manual Compression in Cardiac Interventional Procedures: Systematic Review and Meta-Analysis

Pang

Gao

Zhang

et al. 2022

Cardiovascular Therapeutics

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“…Regarding venous hemostasis, a recent prospective registry compared the Perclose ProGlide system (Abbott Vascular, Sata Clara, CA, USA) and the figure-of-8 suture following catheter ablation in 434 patients (largest sheath was 15 F). There were no differences in complications between both methods and they improved hemostasis and time to ambulation and permitted more same-day discharge compared to manual compression [ 32 ].…”

Section: Access Site Complicationsmentioning

confidence: 99%

Complications of the Percutaneous Mitral Valve Edge-To-Edge Repair: Role of Transesophageal Echocardiography

Flores

Mesa-Rubio

Ojeda

et al. 2022

JCM

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The use of transcatheter edge-to-edge repair for the treatment of mitral regurgitation has markedly increased in the last few years. The rate of adverse events related to the procedure is low; however, some of the complications that may occur are potentially dangerous. Due to the growing popularity of the technique, which is no longer limited to high-volume centers, knowledge of the complications related to the procedure is fundamental. Transesophageal echocardiography has a key role in the guidance of the intervention while allowing for the avoidance of most of these adverse events, as well as enabling us to diagnose them early. In this article, we review the main complications that might present during a transcatheter mitral edge-to-edge repair procedure (tamponade, thromboembolic events, single leaflet device attachment, device embolization, vascular injury…) while highlighting key aspects of transesophageal echocardiographic monitoring in the prevention and prompt diagnosis of these complications.

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“…Venous access is most often via the femoral vein, a logical choice for its large caliber and limited anatomical variation; it consistently accommodates sheaths of up to 24 F inner diameter and 27 F outer diameter [1][2][3][4][5][6]. The veins of the upper body are seldom used as jugular access is uncomfortable for the patient, subclavian or axillary venous access carries a risk of hemothorax or pneumothorax, and the veins of the arm are too small.…”

Section: Introductionmentioning

confidence: 99%

New approaches to achieving hemostasis after venous access in cardiovascular patients

et al. 2022

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Recent decades have seen a series of advances in percutaneous transvenous procedures for cardiac arrhythmias, including the implantation of leadless pacemakers. Many of these procedures require the insertion of large caliber sheaths in large veins, usually the femoral vein. Securing hemostasis efficiently and reliably at the access site is a key step to improving a procedure's safety profile. Traditionally, hemostasis was achieved by manual compression of venous access sites, but the trend toward larger sheaths and the increased use of uninterrupted anticoagulation has pushed the limits of this method. Achieving hemostasis by compression alone in these circumstances requires more attention and longer duration, leading to greater patient discomfort and prolonged immobility. In turn, manual compression may be more time-consuming for medical professionals and increase the number of occupied hospital beds. New approaches have been developed to facilitate early ambulation, decrease patient discomfort, and address the risk of access site complications. These approaches include vascular closure devices and subcutaneous suture techniques including figureof-eight and purse-string sutures. This article reviews the new approaches applied to achieve venous access site hemostasis in patients undergoing transvenous procedures for cardiac arrhythmias.

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Comparative outcomes of vascular access closure methods following atrial fibrillation/flutter catheter ablation: insights from VAscular Closure for Cardiac Ablation Registry

Cited by 18 publications

References 19 publications

Vascular Closure Devices versus Manual Compression in Cardiac Interventional Procedures: Systematic Review and Meta-Analysis

Vascular Closure Devices versus Manual Compression in Cardiac Interventional Procedures: Systematic Review and Meta-Analysis

Complications of the Percutaneous Mitral Valve Edge-To-Edge Repair: Role of Transesophageal Echocardiography

New approaches to achieving hemostasis after venous access in cardiovascular patients

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