Rapid arterial hemostasis and decreased access site complications after cardiac catheterization and angioplasty: Results of a randomized trial of a novel hemostatic device

Abstract

This sheath-deployed, bioabsorbable device provides a safe and effective means of obtaining rapid arterial hemostasis after cardiac catheterization procedures. It appears to be particularly useful in those patients most at risk for access site complications.

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

“…These results are comparable to published data [6,10,15]. ) and its distribution within different subgroups as described on the abscissa.…”

“…Similar procedures have a broad range of hemostatic complication rates for manual compression and VCD [10][11][12][13]. Depending on the definitions, the accuracy of follow-up protocols, and diagnostic tools used, complication rates as high as 64 % have been reported [14].…”

Femoral Arterial Access and Closure

“…Nevertheless, these devices have the potential to reduce the time to hemostasis, facilitate early patient mobilization, decrease hospital length of stay (if same-day discharge is adopted for percutaneous coronary interventions), and improve patient satisfaction. 28,[37][38][39][40][41][42] The commonly available VCDs are listed in Table 2. VCDs are classified as follows 17 : (1) active approximators, in which the device actively approximates the arteriotomy site such as use of anchor and collagen plug (Angio-Seal), suture (Perclose), or a nitinol clip (Starclose), versus passive approximators, in which the arteriotomy is sealed passively by using either a sealant (gel foam) or thrombin, which facilitates clot formation; (2) foreign body versus none, based on whether a foreign body (suture, clip, sealant, anchor, plug) is left behind in the body; (3) extraluminal, in which there is no foreign body left inside the artery, versus intraluminal, in which a foreign body is left inside the artery; and (4) temporary, in which the foreign body gets absorbed over a period of time, versus permanent, in which it stays permanently.…”

Remote suturing for percutaneous closure of popliteal artery access

“…Depending on access site [5][6][7], size of introducer sheath [3,8], and coagulation status [9][10][11] vascular interventional procedures are associated with access site complications such as formation of hematomas, pseudoaneurysms, or arteriovenous fistulas. Therefore, anticoagulation, thrombocytopenia, and other bleeding disorders can be contraindications for an indicated angioplasty.…”

“…To avoid these complications, percutaneous arterial closure devices have been developed for the femoral artery approach. For instance, techniques utilizing collagen plugs have been introduced to shorten time to hemostasis [2,3]. An alternative to those methods is a vascular suture device, which enables the interventionalist to close the vascular access site directly [4].…”