Safety and efficacy of hybrid vascular closure technique using both a suture‐ and collagen‐mediated closure device after transfemoral transcatheter aortic valve implantation

Abstract

Objectives: To evaluate the clinical utility and feasibility of a hybrid technique for obtaining vascular hemostasis by combining a suture-and a collagen-mediated system after transfemoral transcatheter aortic valve implantation (TF TAVI) in a real-world setting.Methods: In 75 consecutive TF TAVI procedures, we investigated a hybrid closing method to achieve hemostasis at the large bore puncture site using a combination of one presuture closure system (ProGlide) and one collagen-mediated system (Angio-Seal). Vascular complications at puncture site were recorded until discharge. Results: Successful hemostasis by the hybrid technique was achieved in 74 out of 75 patients, and the method was well tolerated by all patients. In 73 patients, (97.3%) neither puncture site related complications nor serious early or late bleedings were observed during a median hospital stay of 2 days postprocedure.Conclusion: This single-center registry study indicates that a percutaneous hybrid closure technique is safe and efficacious in closing large bore arteriotomies. It is an easy and reliable technique that may contribute to simplifying TAVI procedures.Study registration: The data was collected from an internal quality control registry on treatment of patients with valvular heart disease with or without coronary artery disease, No 2014/17280,

Feasibility of a modified hybrid glubran-supported single-proglide technique for access closure during endovascular aneurysm repair

“…Moreover, it has been suggested that a hybrid strategy combining suture and plug vascular closure devices may have greater efficacy and a lower risk of subsequent peripheral ischemia after TAVI than double suture devices ( 9 , 22 ). Gmeiner ( 17 ) et al demonstrated that this strategy reduces arterial wall constriction and tension while retaining the benefits of both devices.…”

Impact of Transcatheter Aortic Valve Implantation on Thrombin Generation and Platelet Function

“…Interestingly, bleeding risk decreased during the past years due to evolution of closure devices and TAVI delivery catheters. [34][35][36] Additionally, intraprocedural ACT-guided UFH administration reduced risk for bleeding as well. 9 Moreover, anticoagulation is more effective in preventing leaflet thrombosis in comparison to antiplatelet therapy.…”

Closing up after TAVR

“…Al‐Ani et al 1 report a series of 75 patients who underwent percutaneous closure of the femoral arteriotomy using a “hybrid” closure technique. Much of the vascular access and closure approach in transcatheter aortic valve replacement (TAVR), and indeed so much of the overall procedure itself, is in a state of constant evolution that the entire procedure could be considered a hybrid of devices and methods.…”