Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients

Spiliοpoulos, Stavros; Kitrou, Panagiotis; Christeas, Nikolaos; Karnabatidis, Dimitris

doi:10.5152/dir.2016.15614

Cited by 9 publications

(3 citation statements)

References 21 publications

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“…This technique has been previously reported to be safe and efficient. 27 Increased sheath size was also not correlated with bleeding events, which could also be attributed to operator preference to use closure devices in cases of larger sheath access. The authors would also like to underline the importance of optimal ultrasound-guided arterial access.…”

Section: Discussionmentioning

confidence: 96%

“…Following analysis of the huge Vascular Quality Initiative database (~28,000 patients at 131 centers), Ortiz and colleagues 34 reported similar access site complication rates (3.4%), while again female sex and age >70 years were correlated with access site complications. The authors proposed and validated a score using 7 parameters to stratify patients as low (score 0-15), intermediate (score [16][17][18][19][20][21][22][23][24][25][26][27], or high (score 28-42) risk. However, this score investigated only access site-related complications and therefore cannot be used for the evaluation of all periprocedural bleeding complications, as the proposed PBS.…”

Section: Discussionmentioning

confidence: 99%

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A New Preprocedural Score to Predict Bleeding Complications of Endovascular Interventions for Peripheral Artery Disease

et al. 2019

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Purpose: To investigate the bleeding complications associated with endovascular therapy (EVT) for peripheral artery disease (PAD) and develop a dedicated peripheral bleeding score (PBS). Materials and Methods: This prospective, single-center study enrolled 530 patients (mean age 67.6±9.8 years; 396 men) undergoing endovascular procedures between August 2016 and July 2018 for chronic PAD. Primary endpoints were the incidence of 30-day bleeding complications [minor and major (prolonging hospitalization, causing permanent sequelae, or resulting in death)], the identification of factors associated with bleeding events, and the development of a dedicated PBS based on univariate and multivariate analysis. Hazard ratios (HR) and 95% confidence intervals (CI) are reported. The HAS-BLED score was compared with the PBS. Results: The overall peripheral bleeding complication rate was 3.8% (20/530), of which 3.2% (17/530) were major and included 4 (0.7%) active retroperitoneal bleeding events and 13 (2.4%) pseudoaneurysms. The annualized incidences of overall bleeding and major bleeding complications were 1.9% and 1.6%, respectively. Multivariable regression analysis identified age ≥75 as a correlate of significantly increased bleeding risk (HR 3.32, 95% CI 1.12 to 9.80, p<0.02). Male gender (HR 0.193, 95% CI 0.49 to 0.75, p<0.001) and statin therapy (HR 0.245, 95% CI 0.08 to 0.71, p=0.01) were correlated with a significantly decreased bleeding risk. Based on the regression analysis findings an 8-point PBS was developed, demonstrating 75.0% sensitivity and 78.4% specificity in detecting bleeding complications. The HAS-BLED score failed to identify 30-day bleeding events. Conclusion: The annualized incidence of bleeding complications associated with peripheral EVT was low. Advanced age and female sex were correlated with increased bleeding risk. The PBS demonstrated satisfactory statistical performance and could be considered for inclusion in the preprocedural endovascular checklist to help optimize intra- and postprocedural care.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

A New Preprocedural Score to Predict Bleeding Complications of Endovascular Interventions for Peripheral Artery Disease

et al. 2019

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“…calcifications, scarring, obesity, and anticoagulation). 1,[6][7][8]11 Therefore, the aim of our study was to assess the efficacy and safety of the novel VCD following antegrade common femoral artery (CFA) punctures. In addition, we investigated the efficacy of the novel VCD following retrograde punctures with larger access diameters as previously published.…”

Section: Introductionmentioning

confidence: 99%

A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures

et al. 2021

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Background: This retrospective study investigates the efficacy and safety of the novel Celt ACD® vascular closure device (VCD) following antegrade and retrograde common femoral artery (CFA) punctures for the treatment of peripheral artery disease in a challenging patient collective (e.g. calcifications, obesity, and anticoagulation). Methods: A total of 208 VCDs (i.e. 100 antegrade and 108 retrograde) were deployed between October 2019 and December 2020 in a tertiary referral interventional radiology department. Fifty-two devices were undersized in relation to the introducer sheath (up to 2 Fr). Technical success and VCD related complications were evaluated in the immediate post procedure period and the following 24 h clinically. In 68% of cases, additional duplex ultrasound was performed prior to discharge. Results: The overall technical success rate was 97%. Technical failures following antegrade approach were due to a too acute access angle (⩾60°), rendering it impossible to pass the applicator tip through the sheath lumen. A subgroup analysis of technical success pinpoints severe calcification as another key limiting factor in VCD use ( p = 0.004). Comparing equally sized with undersized device selection ( p = 0.196), direction of approach ( p = 0.265), and body mass index ( p = 0.184) proved to be insignificant. Five (2%, 5/208) major complications occurred: Four antegrade (i.e. one false aneurysm, one vessel laceration with retroperitoneal hemorrhage, two device migrations; 4%, 4/100) and one following retrograde access (i.e. >6 cm hematoma, 1%, 1/108)). Complications were successfully managed with manual compression or interventional procedures. Conclusions: The novel clip-based VCD proved to be effective with a low VCD related complication rate.

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Tibial and Pedal Plantar Interventions in Patients with Critical Limb Ischemia

Prasad

Hughston

2018

Endovascular Interventions

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Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients

Cited by 9 publications

References 21 publications

A New Preprocedural Score to Predict Bleeding Complications of Endovascular Interventions for Peripheral Artery Disease

A New Preprocedural Score to Predict Bleeding Complications of Endovascular Interventions for Peripheral Artery Disease

A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures

Tibial and Pedal Plantar Interventions in Patients with Critical Limb Ischemia

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