Editor's Choice – Arteriotomy Closure Devices in EVAR, TEVAR, and TAVR: A Systematic Review and Meta-analysis of Randomised Clinical Trials and Cohort Studies

Abstract

This meta-analysis favours ACD regarding the number of wound complications compared with SCD in endovascular aneurysm repair, thoracic endovascular aneurysm repair, and transcatheter aortic valve repair. Treatment duration (DOS and HLOS) was not reduced in ACD. The differences are of limited clinical significance and with this equivocal quality of evidence, the ACD may be considered safe for CFA access in suitable patients.

Impact of percutaneous closure device type on vascular and bleeding complications after TAVR: A post hoc analysis from the BRAVO‐3 randomized trial

“…A number of vascular closure devices (VCD) have been used as a means of decreasing vascular complications and therefore the consequent blood loss and transfusion requirements associated with arteriotomy site closure. Compared to surgical cut‐down techniques, the use of VCD may reduce wound healing complications, hospital length of stay and potentially, and procedural duration …”

“…Compared to surgical cut-down techniques, the use of VCD may reduce wound healing complications, hospital length of stay and potentially, and procedural duration. 9 The Prostar XL (PS) and ProGlide (PG) (both by Abbott Vascular Inc., Santa Clara, CA) devices are commonly used in transfemoral TAVR. 10 Many studies examining VCD type and vascular outcomes have, to date, been limited by small sample sizes, mixed patient populations, with heterogeneous outcomes.…”

Access site complications in transcutaneous aortic valve replacement: frequency, outcomes, prevention, and treatment

“…ACDs showed advantage in prevention of postoperative surgical site infections, while SCD indicated benefit in prevention of pseudoaneurysm formation. However, overall ACDs showed slight advantage with a lower percent of complications (6.8%) versus SCD (8.0%) (23). Unfortunately, this study had some limitations, including sample size and complication reporting.…”

Minimally invasive isolated limb perfusion – technical details and initial outcome of a new treatment method for limb malignancies

“…This was the main reason for choosing the latter for our minimally invasive method, however, there might very well be other, even more, suitable catheters available. These catheter sizes are also commonly used in vascular and cardiac procedures, and the risks for adverse events such as stenosis, thrombosis and pseudoaneurysms are usually regarded low [21].…”