Mangaladevi S Patil1, Mahesh V Jayaraman2, Sun H Ahn2. 1. The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, United States. Electronic address: Mangaladevi_Patil@Brown.edu. 2. The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, United States; Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, United States; Department of Diagnostic Imaging, Miriam Hospital, 164 Summit Ave, Providence, RI 02906, United States.
Abstract
OBJECTIVES: To determine the safety and effectiveness of vascular closure devices in prevention of access site complications in acute stroke patient receiving intravenous (IV) and/or intra-arterial (IA) IV tissue plasminogen activator (tPA). PATIENTS AND METHODS: All patients with acute stroke onset treated with IV and/or IA tPA closed with vascular closure device and adult age (>18 years) were identified from an academic tertiary medical center and a teaching community hospital stroke database for 9 years (from March 2005 to June 2014). RESULTS: A total of 69 patients were included in the study. The mean age was 68.86±16.70 years and 49.2% female. All accesses were under fluoroscopic guidance into the right common femoral artery. We observed a 5.8% complication rate in patients receiving IV and/or IA tPA closed with vascular closure device. Access site complications included 3 cases of hematoma and 1 case of residual oozing. One patient required transfusion due to access site hematoma. Three patients were on aspirin and heparin and 1 was on no prior anticoagulation. CONCLUSIONS: Vascular closure device access site hemorrhagic complication rate in those receiving IV and/or IA tPA is low and similar to reported rates in those not receiving thrombolytic therapy. Vascular closure device use in patients receiving thrombolytic therapy is safe and effectively achieves hemostasis.
OBJECTIVES: To determine the safety and effectiveness of vascular closure devices in prevention of access site complications in acute strokepatient receiving intravenous (IV) and/or intra-arterial (IA) IV tissue plasminogen activator (tPA). PATIENTS AND METHODS: All patients with acute stroke onset treated with IV and/or IA tPA closed with vascular closure device and adult age (>18 years) were identified from an academic tertiary medical center and a teaching community hospital stroke database for 9 years (from March 2005 to June 2014). RESULTS: A total of 69 patients were included in the study. The mean age was 68.86±16.70 years and 49.2% female. All accesses were under fluoroscopic guidance into the right common femoral artery. We observed a 5.8% complication rate in patients receiving IV and/or IA tPA closed with vascular closure device. Access site complications included 3 cases of hematoma and 1 case of residual oozing. One patient required transfusion due to access site hematoma. Three patients were on aspirin and heparin and 1 was on no prior anticoagulation. CONCLUSIONS: Vascular closure device access site hemorrhagic complication rate in those receiving IV and/or IA tPA is low and similar to reported rates in those not receiving thrombolytic therapy. Vascular closure device use in patients receiving thrombolytic therapy is safe and effectively achieves hemostasis.