Postinterventional percutaneous closure of femoral artery access sites using the Clo-Sur PAD device: initial findings

Balzer, J. O.; Schwarz, W.; Thalhammer, A.; Eichler, Katrin; Schmitz‐Rixen, Thomas; Vogl, Thomas J.

doi:10.1007/s00330-006-0279-1

Cited by 25 publications

(19 citation statements)

References 15 publications

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“…The procoagulant components of the noninvasive PACDs include, among others, bovine thrombin (D-Stat-Dry-Vascular Solutions), poly-N-acetyl glucosamine derived from marine diatoms (Syvek Patch-Marine Polymer Technologies), polyprolate acetate (Clo-Sur Pad – Scion Cardiovascular) and chitosan obtained from exoskeleton of crustaceans (Chito-Seal, Abbot Vascular, HemCon ® Bandage). Clinical studies of D-Stat-Dry, Syvek Patch, Clor-Sur Pad and Chito-Seal showed that these PACDs applied with compression reduce time to hemostasis after femoral artery catheterization compared with SMC and do not increase the complication rate when using 4–6 F sheaths 8,10,12–14…”

Section: Discussionmentioning

confidence: 99%

Hemostatic efficacy of chitosan-based bandage for closure of percutaneous arterial access sites: An experimental study in heparinized sheep model

Kranokpiraksa

Pavčnik

Kakizawa

et al. 2010

Radiology and Oncology

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BackgroundMost of the presently used percutaneous arterial closure devices (PACD) for hemostasis after interventional vascular procedures are effective, but carry risk of complications by deposition of a foreign body. A new promising externally applied PACD – chitosan-based HemCon Bandage (HCB) was explored in sheep. The HCB hemostatic efficacy and complications occurring with its use were compared to those with the standard manual compression (SMC).Material and methodsBoth superficial femoral arteries (SFA) of 9 heparinized sheep were catheterized with an 8F sheath for 5 minutes. After the sheath withdrawal, hemostasis with the HCB was compared with hemostasis achieved with SMC in the contralateral SFA. Iliac angiograms performed by carotid artery approach determined the hemostasis time.ResultsThe HCB use shortened time to hemostasis with a mean time of 6.9 ± 3.9 minutes versus 10.8 ± 2.8 minutes for the SMC (P-value 0.019). Seven SFAs in the HCB group and only 1 SFA in the SMC group exhibited hemostasis in 5 minutes. All nine SFAs using the HCB showed femoral artery patency and demonstrated less hematoma (2/9) than in the SMC group (8/9). No complications developed in the HCB group, one SFA occlusion was seen in the SMC group.ConclusionsThe externally applied HCB in heparinized sheep was safe and effective. It significantly shortened time to hemostasis at the SFA access sites following 8F sheath removal. Proper application of the HCB was necessary to shorten hemostasis and prevent hematoma formation. The HCB should be tested in a clinically controlled study to evaluate its efficacy in humans.

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Section: Discussionmentioning

confidence: 99%

Hemostatic efficacy of chitosan-based bandage for closure of percutaneous arterial access sites: An experimental study in heparinized sheep model

Kranokpiraksa

Pavčnik

Kakizawa

et al. 2010

Radiology and Oncology

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“…Mlekusch et al [9] demonstrated only a minimal reduction in the time to haemostasis, no difference in the time to ambulation and a greater incidence of minor bleeding and complications with the use of a haemostasis pad. Balzer et al [10] demonstrated reduced time for haemostasis and time to ambulation with the use of a haemostasis pad versus conventional MC, but they routinely applied a pressure bandage at the access site for a minimum of 2 h following compression with the haemostasis pad and overall times to haemostasis and required time for application of a pressure bandage (mean 10.15 min and 3.47 h, respectively) remained relatively high in the haemostasis pad group. Small RCTs in the cardiology literature have similarly demonstrated only small reductions in the time required for compression and no significant reduction in the time to ambulation or higher rates of technical failure with haemostasis pads compared to conventional MC [11,12].…”

Section: Non-invasive Adjuncts To Manual Compressionmentioning

confidence: 95%

“…Haemostatic pads are coated with procoagulant material to promote clotting and haemostasis but still require a degree of MC and a period of bedrest. There are two, relatively small, published randomised controlled trials (RCTs) in IR, comparing compression with haemostasis pads and compression with conventional MC [9,10]. Mlekusch et al [9] demonstrated only a minimal reduction in the time to haemostasis, no difference in the time to ambulation and a greater incidence of minor bleeding and complications with the use of a haemostasis pad.…”

Section: Non-invasive Adjuncts To Manual Compressionmentioning

confidence: 98%

Vascular Closure Devices in Interventional Radiology Practice

Patel

Müller‐Hülsbeck

Morgan

et al. 2015

Cardiovasc Intervent Radiol

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Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

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“…In-hospital RCTs performed in patients after endovascular procedures 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 demonstrated more rapid bleeding cessation with the use of haemostatic dressings plus direct manual pressure compared with direct manual pressure alone. Many patients in these studies also received anticoagulant medications.…”

Section: First Aidmentioning

confidence: 98%

Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Nolan¹,

Maconochie²,

Soar³

et al. 2020

Resuscitation

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requiring first aid, related education and implementation strategies, and systems of care. After the publication of the 2015 International Consensus on CPR and ECC Science With Treatment Recommendations, ILCOR also committed to sponsoring a continuous evidenceevaluation process, with topics prioritized for review by the task forces and with CoSTR updates published annually. For this 2020 CoSTR, the 6 ILCOR task forces performed structured reviews of 184 topics, completing the most ambitious evidence review that ILCOR has attempted to date.The ILCOR systematic review process continues to be based on the methodological principles published by the National Academy of Health and Medicine (formerly the Institute of Medicine) 2 ; Cochrane 3,4 ; Grading of Recommendations Assessment, Development, and Evaluation (GRADE) 5 ; and the reporting guidelines based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. 6,7 Three types of evidence evaluation provided the basis for this 2020 CoSTR: the systematic review, the scoping review, and the evidence update. Based on recommendations from the ILCOR Scientific Affairs Committee and agreement of the task forces, only systematic reviews could result in new or modified treatment recommendations.

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Postinterventional percutaneous closure of femoral artery access sites using the Clo-Sur PAD device: initial findings

Cited by 25 publications

References 15 publications

Hemostatic efficacy of chitosan-based bandage for closure of percutaneous arterial access sites: An experimental study in heparinized sheep model

Hemostatic efficacy of chitosan-based bandage for closure of percutaneous arterial access sites: An experimental study in heparinized sheep model

Vascular Closure Devices in Interventional Radiology Practice

Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

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