Sukhdeep Bhogal1, Ron Waksman2. 1. Section of Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving St.Suite 4B-1, Washington, NWDC, 20010, USA. 2. Section of Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving St.Suite 4B-1, Washington, NWDC, 20010, USA. ron.waksman@medstar.net.
Abstract
PURPOSE OF REVIEW: Vascular access and closure is a key part of endovascular procedures, and access site-related complications are an independent predictor of adverse procedural outcomes. The purpose of this review is to discuss the methods of vascular closure including manual compression, vascular closure devices (VCDs) for both arterial and venous arteriotomies, their mechanisms, and access site-related complications. RECENT FINDINGS: Various VCDs have been approved over the last three decades. These devices have different mechanisms to achieve hemostasis and are generally categorized into active and passive approximators. Studies have largely found that they are non-inferior to manual compression. Uncomplicated vascular closure is pertinent to avoid adverse procedure-related outcomes. The emergence of VCDs has reduced time to hemostasis, facilitating early ambulation and discharge and reducing hospitalization cost with comparable complication rate to manual compression. Nonetheless, they should be used in favorable vascular anatomy and are not intended to reduce complications.
PURPOSE OF REVIEW: Vascular access and closure is a key part of endovascular procedures, and access site-related complications are an independent predictor of adverse procedural outcomes. The purpose of this review is to discuss the methods of vascular closure including manual compression, vascular closure devices (VCDs) for both arterial and venous arteriotomies, their mechanisms, and access site-related complications. RECENT FINDINGS: Various VCDs have been approved over the last three decades. These devices have different mechanisms to achieve hemostasis and are generally categorized into active and passive approximators. Studies have largely found that they are non-inferior to manual compression. Uncomplicated vascular closure is pertinent to avoid adverse procedure-related outcomes. The emergence of VCDs has reduced time to hemostasis, facilitating early ambulation and discharge and reducing hospitalization cost with comparable complication rate to manual compression. Nonetheless, they should be used in favorable vascular anatomy and are not intended to reduce complications.
Authors: Eugenia Nikolsky; Roxana Mehran; Amir Halkin; Eve D Aymong; Gary S Mintz; Zoran Lasic; Manuela Negoita; Martin Fahy; Shoshana Krieger; Issam Moussa; Jeffrey W Moses; Gregg W Stone; Martin B Leon; Stuart J Pocock; George Dangas Journal: J Am Coll Cardiol Date: 2004-09-15 Impact factor: 24.094
Authors: James B Hermiller; Wayne Leimbach; Roger Gammon; Steven P Karas; Robert J Whitbourn; S Chiu Wong; Nilesh Goswami; John McCabe; Nick G Cavros; Richard Paulus; Srihari S Naidu; Zoltan G Turi Journal: J Invasive Cardiol Date: 2015-03 Impact factor: 2.022
Authors: Anthony A Bavry; Russell E Raymond; Deepak L Bhatt; Charles E Chambers; Andrew J DeNardo; James B Hermiller; Paul R Myers; Douglas E Pitts; John A Scott; Scott J Savader; Steven Steinhubl Journal: J Invasive Cardiol Date: 2008-04 Impact factor: 2.022