Tsung-Yu Ko1, Hsien-Li Kao2, Ying-Ju Liu3, Chih-Fan Yeh2, Ching-Chang Huang2, Ying-Hsien Chen2, Chi-Sheng Hung2, Chih-Yang Chan4, Lung-Chun Lin2, Yih-Sharng Chen4, Mao-Shin Lin5. 1. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Graduate Institute of Clinical Medicine, Medical College, National Taiwan University, Taipei, Taiwan. 2. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 3. Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan. 4. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. 5. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: linmaoshin@gmail.com.
Abstract
BACKGROUND: To describe and evaluate the intentional combination of Angio-Seal (AS) and Perclose ProGlide (PP) in achieving haemostasis in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). METHODS: This study cohort was divided into two groups: dual PP versus one AS with one PP (AS + PP) used for common femoral artery haemostasis. The baseline, procedural characteristics and all outcomes (defined according toVARC-2 criteria) were prospectively collected and retrospectively compared. RESULTS: Overall, a total of 151 consecutive patients (68 men; 80.9 ± 7.3 years old) were evaluated. Of these, 51 patients (33.8%) underwent TAVR using the dual PP, and 100 (66.2%) using one AS with one PP. There were no significant differences in the baseline characteristics of both patient groups, except higher incidence of chronic pulmonary disease in dual PP group (21.6% vs 7%, P = 0.009). Patients in AS + PP group had lower rate of arterial stricture (21.6% vs 8%, P = 0.017), arterial dissection (13.7% vs 4.0%), requiring endovascular intervention for puncture site issues (21.6% vs 9.0%, P = 0.031). Less procedural time (139.8 ± 36.9vs97.9 ± 31.4 min, P < 0.001) & contrast medium consumption (223.9 ± 88.3vs174.1 ± 49.7 ml, P < 0.001) were also observed in AS+PP group. There were no statistically significant differences between 2 groups in regards of closure device failure, major and minor vascular complications, nor major and minor bleeding. CONCLUSIONS: Intentional combination of one PP and one AS for femoral access haemostasis in patients undergoing TAVR is feasible and safe, with low risk of vascular and bleeding complications.
BACKGROUND: To describe and evaluate the intentional combination of Angio-Seal (AS) and Perclose ProGlide (PP) in achieving haemostasis in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). METHODS: This study cohort was divided into two groups: dual PP versus one AS with one PP (AS + PP) used for common femoral artery haemostasis. The baseline, procedural characteristics and all outcomes (defined according toVARC-2 criteria) were prospectively collected and retrospectively compared. RESULTS: Overall, a total of 151 consecutive patients (68 men; 80.9 ± 7.3 years old) were evaluated. Of these, 51 patients (33.8%) underwent TAVR using the dual PP, and 100 (66.2%) using one AS with one PP. There were no significant differences in the baseline characteristics of both patient groups, except higher incidence of chronic pulmonary disease in dual PP group (21.6% vs 7%, P = 0.009). Patients in AS + PP group had lower rate of arterial stricture (21.6% vs 8%, P = 0.017), arterial dissection (13.7% vs 4.0%), requiring endovascular intervention for puncture site issues (21.6% vs 9.0%, P = 0.031). Less procedural time (139.8 ± 36.9vs97.9 ± 31.4 min, P < 0.001) & contrast medium consumption (223.9 ± 88.3vs174.1 ± 49.7 ml, P < 0.001) were also observed in AS+PP group. There were no statistically significant differences between 2 groups in regards of closure device failure, major and minor vascular complications, nor major and minor bleeding. CONCLUSIONS: Intentional combination of one PP and one AS for femoral access haemostasis in patients undergoing TAVR is feasible and safe, with low risk of vascular and bleeding complications.