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Palmier M, Amarouche H, Teniere T, Bernard G, Pochulu B, Fares Y, Miranda S, Plissonnier D. Enhancing Arterial Closure in Endovascular Aortic Procedures: The Efficacy of Echo-Guided ProGlide Technique. Ann Vasc Surg 2024; 105:125-131. [PMID: 38588952 DOI: 10.1016/j.avsg.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/27/2024] [Accepted: 02/06/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Endovascular aortic surgery is increasingly becoming the standard treatment. Percutaneous access preclosing systems appear to be effective and notably the Proglide (PG). We aimed to prospectively assess the clinical effectiveness of combining ultrasound-guided femoral puncture with ultrasound-guided PG deployment. METHODS Our single-center study consecutively included patients managed at a tertiary center from May to September 2023, undergoing endovascular aortic surgery. The placement of PG was performed under ultrasound guidance. Preoperative patient characteristics were evaluated using preoperative computed tomography scans. Clinical and technical success were defined, respectively, as the ability to achieve complete hemostasis confirmed by ultrasound 48 hr postprocedure and as the successful placement of a PG under ultrasound guidance contributing to final hemostasis. RESULTS Twenty patients were included over a 6-month period, totaling 34 common femoral arteries (CFAs). Fourteen were male, with an average age of 72.8 ± 8.2 years. Among the 34 CFA, CFA had diameter of 12.05 ± 2.4 mm and a depth of 38.0 ± 13.4 mm. The mean introducer sheath diameter was 6.2 ± 1.5 mm with a sheath to femoral artery ratio of 0.54 ± 0.18. Successful Proglide placement under ultrasound guidance was achieved in 100% of cases. No PG failure occurred. Clinical and technical success were, respectively, of 95% and 100%. One small pseudoaneurysm was observed at 48 hr treated medically. No CFA access reintervention was required. CONCLUSIONS The technique of ultrasound-guided PG deployment in aortic surgery is a safe and effective method for achieving hemostasis. It effectively prevents PG failures at a lower cost.
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Affiliation(s)
- Mickael Palmier
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France.
| | - Hossam Amarouche
- Department of Vascular Medicine, Rouen University Hospital, Rouen, France
| | - Tom Teniere
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France
| | - Geoffrey Bernard
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France
| | - Bruno Pochulu
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France
| | - Yara Fares
- Department of Vascular Medicine, Rouen University Hospital, Rouen, France
| | - Sebastien Miranda
- Department of Vascular Medicine, Rouen University Hospital, Rouen, France
| | - Didier Plissonnier
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France
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Devasia T, Premchand RK, Sinha SK, Rewatkar A, Parikh K, Arneja J. Comparing Obtura Vascular Closure Device to Manual Compression for Achieving Hemostasis After Percutaneous Transfemoral Procedures: A Randomized Study. J Endovasc Ther 2024:15266028241258662. [PMID: 39044646 DOI: 10.1177/15266028241258662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
PURPOSE This trial was designed and aimed to compare safety and efficacy of Obtura™ vascular closure device (VCD) to manual compression (MC) among patients undergoing transfemoral catheterization. MATERIAL AND METHODS This prospective, randomized, controlled, multicenter trial of Obtura VCD against MC randomized patients in 1:1 (n=268; 134:134) ratio. Safety and efficacy were measured by primary endpoints (time to hemostasis [TTH] and deployment success) and secondary endpoints which included technical success, device-related adverse events, and time to ambulation (TTA). RESULTS The procedural access using right femoral artery was performed in 95.52% of patients in Obtura VCD versus 96.27% in standard MC method, whereas 2.99% of patients in each group underwent left femoral access. Bilateral access was performed in 1.49% (n=2) versus 0.75% (n=1) in Obtura VCD versus MC, respectively. Both the technical success and deployment success were 100%. Patients in Obtura VCD group had shorter TTH (3.26±3.39 vs 23.95±8.24 minutes; p<0.0001) and TTA (155.44±125.32 vs 723.84±197.98 minutes; p<0.0001) than MC group. No access site complications (re-bleeding, infection, arteriovenous fistula, and transient access site nerve injury) were noted at 2-week, 1-month, and 3-month follow-ups. There were 4 (3%) and 6 (4.5%) cases of hematoma, respectively, in Obtura VCD versus MC and 1 case (0.7%) of post-procedural arterial pseudoaneurysm each in both the groups which were successfully resolved and patients were discharged with no further complications. Further follow-up was without any adverse events. CONCLUSIONS The study demonstrated favorable safety and efficacy of Obtura™ VCD with a significantly short TTH and TTA compared to MC. CLINICAL IMPACT In patients undergoing cardiac catheterization, vascular closure devices (VCDs) can achieve hemostasis faster after successful implantation of the device with fewer complications such as bleeding and ambulation can be achieved faster. In terms of effectiveness, Obtura VCD was found to be better than manual compression in achieving early hemostasis and higher technical and deployment success was accomplished. Obtura VCD does not require enlargement of the route through the tissues, uses the same existing arterial sheath as its conduit, and does not cause patients' access sites to feel uncomfortable while it is being deployed.
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Affiliation(s)
- Tom Devasia
- Department of Cardiology, Kasturba Medical College Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Santosh K Sinha
- LPS Institute of Cardiology and Cardiac Surgery, Kanpur, Uttar Pradesh, India
| | - Atul Rewatkar
- Pulse Clinic and Hospital, Nagpur, Maharashtra, India
| | - Keyur Parikh
- Care Institute of Medical Sciences (CIMS) Hospital, Ahmedabad, Gujarat, India
| | - Jaspal Arneja
- Arneja Heart and Multispeciality Hospital, Nagpur, Maharashtra, India
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Sanguettoli F, Pavasini R, Nobile G, Pricoco F, Tasneem S, Biscaglia S, Tumscitz C, Campo G, Casella G, Iannopollo G. "Safe Femoral" Artery Approach in Endovascular Procedures: A Systematic Review of Its Safety and Feasibility. Curr Probl Cardiol 2024; 49:102114. [PMID: 37802172 DOI: 10.1016/j.cpcardiol.2023.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
Femoral access site-related bleeding represent a prognostically impactful issue in interventional cardiology. The impact of a combined use of ultrasound guidance for femoral access and vascular closure device deployment for arteriotomy closure in femoral artery procedures on bleeding complications is still largely unknown. A systematic review was conducted on Pubmed (Medline), Cochrane library and Biomed Central databases between March and April 2023. A total of 9 studies have been selected, of namely 4 registries, 4 prospective studies and one randomized clinical trial. A systematic use of US guidance to access femoral artery resulted feasible and not time consuming, reduced venipuncture and increased first attempt success. Combination of US guidance and deployment of VCD's had the capacity to further decrease vascular and bleeding combination, especially in those patients at a higher risk of post-procedural bleeding. Ultrasound can be easily used during closure device deployment to reduce device failure and major vascular complications.
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Affiliation(s)
| | - Rita Pavasini
- UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
| | | | - Francesco Pricoco
- UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
| | - Samia Tasneem
- Heart Transplant Fellow, St Vincent's Hospital Darlinghurst, New South Wales, Australia
| | - Simone Biscaglia
- UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
| | - Carlo Tumscitz
- UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
| | - Gianluca Campo
- UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
| | - Gianni Casella
- UOC Cardiologia, Ospedale Maggiore Bologna, Bologna, Italy
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Kobayashi T, Hamamoto M, Okazaki T, Tomota M, Fujiwara T, Yoshitomi Y, Takahashi S. Efficacy and Safety of Ultrasound-Guided Repeat Access and Repeat Closure With an ExoSeal Vascular Closure System in Patients With Peripheral Arterial Disease. Vasc Endovascular Surg 2021; 56:24-28. [PMID: 34547942 DOI: 10.1177/15385744211045508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided repeat access and repeat closure with an ExoSeal vascular closure system. METHODS A total of 123 endovascular therapy (EVT) procedures were performed in 59 patients (65 limbs) with ultrasound-guided repeat access and repeat implantation of an ExoSeal vascular closure system between January 2019 and March 2021. The procedural details and postprocedural outcomes of EVT with repeat access and use of ExoSeal (RE group) were compared with those of EVT with initial use of ExoSeal (IE group) in the same patients. In a subgroup analysis, these outcomes were also compared in early repeat (within 3 months) and late repeat (over 3 months) cases. RESULTS The technical success rate of ultrasound-guided access in the RE group was 100%. The procedural success rate of EVT and deployment success rate of ExoSeal in the RE group were 93% and 94%, respectively, which were not significantly different to those in the IE group. Access site complications in the RE group occurred in 2 cases (2%), again with no significant difference with the IE group. The median puncture, procedural, and hemostasis times in the RE group were 3 [2-5], 36.5 [29-54], and 7 [5-10] min, respectively, which were not significantly longer than those in the IE group. In the RE group, early and late repeat closure was performed in 66 (54%) and 57 (46%) cases, respectively, and there were no significant differences in the technical success of ultrasound-guided access, procedural success of EVT, deployment success of ExoSeal, and access site complication rates in these cases. CONCLUSIONS Ultrasound-guided access facilitated higher technical success of repeat access and fewer access site complications in EVT with repeat use of ExoSeal, regardless of the interval between procedures.
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Affiliation(s)
- Taira Kobayashi
- Department of Cardiovascular Surgery, 13754JA Hiroshima General Hospital, Hiroshima, Japan
| | - Masaki Hamamoto
- Department of Cardiovascular Surgery, 13754JA Hiroshima General Hospital, Hiroshima, Japan
| | - Takanobu Okazaki
- Department of Cardiovascular Surgery, 13754JA Hiroshima General Hospital, Hiroshima, Japan
| | - Mayu Tomota
- Department of Cardiovascular Surgery, 13754JA Hiroshima General Hospital, Hiroshima, Japan
| | - Takashi Fujiwara
- Department of Cardiology, 13754JA Hiroshima General Hospital, Hiroshima, Japan
| | - Yuki Yoshitomi
- Department of Cardiology, 13754JA Hiroshima General Hospital, Hiroshima, Japan
| | - Shinya Takahashi
- Department of Cardiovascular Surgery, 12803Hiroshima University, Hiroshima, Japan
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ULSOSEAL Technique: A Unique Technique to Achieve Hemostasis Using ExoSeal in High-Risk Patients after Common Femoral Artery Puncture. J Interv Cardiol 2021; 2021:2470333. [PMID: 34526872 PMCID: PMC8419493 DOI: 10.1155/2021/2470333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to assess the safety and feasibility of the ULtrasound-guided uSe Of exoSEAL technique (ULSOSEAL technique) in patients at a high risk of complications following the use of ExoSeal. ExoSeal is a novel, completely extravascular hemostatic device that can treat punctures of the common femoral artery; however, it is not preferable for use in cases that require hemostasis of complex puncture sites. From November 2019 to August 2020, the ULSOSEAL technique was performed in 35 patients with implanted stents (6 patients, 17%), severe calcification (32 patients, 91%), and plaque (7 patients, 20%) around the puncture site; the presence of these conditions is usually undesirable when using ExoSeal. The antegrade approach was used in 22 patients (71%). The size of the ExoSeal used was 5 Fr (13 patients, 37%), 6 Fr (21 patients, 60%), and 7 Fr (1 patient, 2%). Technical success was achieved in 34 patients (97%), while ExoSeal malfunction occurred in 1 patient. There was no incidence of vessel occlusion, pseudoaneurysm, arteriovenous fistula, infection, and secondary bleeding. One patient developed a hematoma (>5 cm in size); however, it occurred before the use of ExoSeal due to side leakage from the inserted sheath. The ULSOSEAL technique was safe and feasible for hemostasis in patients who were considered unsuitable for the ExoSeal device.
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Iannopollo G, Nobile G, Lanzilotti V, Capecchi A, Verardi R, Bruno M, Somaschini A, Rubboli A, Di Pasquale G, Casella G. Percutaneous artErial closure devices and ultrasound-guided Trans-femoRal puncture ObservatioNal InvestigatiOn: Insights from the PETRONIO registry. Catheter Cardiovasc Interv 2021; 99:795-803. [PMID: 34137485 DOI: 10.1002/ccd.29828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/05/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the safety of a single and combined use of ultrasound-guided femoral puncture (U) and percutaneous arterial closure devices (P) in femoral artery procedures (FAP) compared to fluoroscopic guidance (F) and manual compression (M) in a large radial-focused interventional centre. BACKGROUND U and P, taken individually, have improved safety in femoral arterial access procedures compared to traditional techniques. METHODS All FAP performed between July 2017 and December 2018 in our centre were divided into three phases: (a) control period with F and M mainly performed; (b) phase out period where U and P were introduced; (c) intervention period where a 6-month expertise on the novel techniques was acquired. The overall population was further stratified into subgroups: F/M, U/M, F/P, U/P. The primary study endpoint was in-hospital access site bleeding events (BE) according to the BARC criteria. The secondary endpoint was vascular site complications (VASC). RESULTS Four hundred eighteen procedures (14%) out of 3025 were performed via FA access during the study period. The overall access-site in-hospital BE were 97 (23%). Decreasing rates of BE (phase 1: n = 46, 29%; phase 2: n = 38, 22% e phase 3: n = 13, 15%; p = 0.027) and VASC were observed during the three periods. BE occurred significantly more often in F/M group (F/M: n = 48; 32%; U/M: n = 12, 16%; F/P: n = 18, 21%; U/P: n = 19, 17%; p = 0.008). F/M subgroup was an independent predictor of BE both in multivariable analysis and propensity score matching analysis. CONCLUSIONS The introduction of ultrasound-guided femoral puncture and percutaneous arterial closure devices has reduced access site bleedings with a progressive improvement after the first 6 months learning period.
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Affiliation(s)
| | | | | | | | | | - Matteo Bruno
- UOC Cardiologia, Ospedale Maggiore, Bologna, Italy
| | | | - Andrea Rubboli
- Divisione di Cardiologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
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Fukuda K, Okazaki S, Shiozaki M, Okai I, Nishino A, Tamura H, Inoue K, Sumiyoshi M, Daida H, Minamino T. Ultrasound-guided puncture reduces bleeding-associated complications, regardless of calcified plaque, after endovascular treatment of femoropopliteal lesions, especially using the antegrade procedure: A single-center study. PLoS One 2021; 16:e0248416. [PMID: 33711058 PMCID: PMC7954350 DOI: 10.1371/journal.pone.0248416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background A common complication of endovascular treatment for femoropopliteal lesions is bleeding at the vascular access site. Although risk factors of bleeding-associated complications at the approach site have been reported, the results have been inconclusive. Hence, this study aimed to assess the predictors of bleeding-associated complications at the approach site in patients undergoing endovascular treatment for femoropopliteal lesions. Methods This retrospective, single-center, observational study included consecutive patients who underwent endovascular treatment (n = 366, 75% male, 72.4±9.9 year) for peripheral arterial disease with claudication and critical limb ischemia in our hospital from January 2010 to December 2017. We divided the patients into bleeding and non-bleeding groups, depending on whether bleeding-associated complications occurred at the approach site. Bleeding-associated complications were defined according to the Bleeding Academic Research Consortium criteria types 2, 3, and 5. Results Altogether, 366 endovascular treatment procedures and 404 arterial accesses were performed for femoropopliteal lesions in 335 peripheral arterial disease patients with claudication and 69 critical limb ischemia patients. We recorded 35 postprocedural bleeding-associated complications at the approach site (9%), all of which were hematomas. The predictors of increased bleeding-associated complications were age ≥ 80 years (bleeding vs. non-bleeding group, 43% vs. 25%, p<0.05) and antegrade cannulation of the common femoral artery (48% vs. 69%, p<0.05). Ultrasound-guided puncture reduced bleeding-associated complications (odds ratio, 0.28; 95% confidence interval, 0.004–0.21; p<0.05). In contrast, there was no significant difference in puncture site calcification between the groups (bleeding vs. non-bleeding groups, 29% vs. 21%, p = 0.29). Conclusion Ultrasound-guided puncture is associated with a decrease in bleeding-associated complications at the approach site, regardless of the presence of calcified plaque. It is particularly effective and should be more actively used in patients aged ≥80 years and for antegrade cannulation of the common femoral artery.
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Affiliation(s)
- Kentaro Fukuda
- Department of Cardiology, Juntendo University Nerima Hospital, Nerimaku, Tokyo, Japan
| | - Shinya Okazaki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- * E-mail:
| | - Masayuki Shiozaki
- Department of Cardiology, Juntendo University Nerima Hospital, Nerimaku, Tokyo, Japan
| | - Iwao Okai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihisa Nishino
- Department of Cardiology, Nishino Naika Clinic, Yamanashi, Japan
| | - Hiroshi Tamura
- Department of Cardiology, Juntendo University Nerima Hospital, Nerimaku, Tokyo, Japan
| | - Kenji Inoue
- Department of Cardiology, Juntendo University Nerima Hospital, Nerimaku, Tokyo, Japan
| | - Masataka Sumiyoshi
- Department of Cardiology, Juntendo University Nerima Hospital, Nerimaku, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Fujihara M, Yazu Y, Takahara M. Intravascular Ultrasound–Guided Interventions for Below-the-Knee Disease in Patients With Chronic Limb-Threatening Ischemia. J Endovasc Ther 2020; 27:565-574. [DOI: 10.1177/1526602820935606] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To assess the utility of intravascular ultrasound (IVUS) during below-the-knee (BTK) interventions for patients with chronic limb-threatening ischemia (CLTI). Materials and Methods: This retrospective single-center study included 216 symptomatic patients (mean age 74.2±9.5 years; 167 men) with CLTI and BTK steno-occlusive disease who underwent successful balloon angioplasty between January 2016 and August 2018. Data from 88 vessels (58 patients) treated with IVUS-guided procedures were compared with corresponding values from 242 vessels (158 patients) treated with angiography-guided procedures. The primary outcomes included procedure-related variables of balloon size, contrast dose, and complication rates, as well as changes in ankle-brachial index (ABI) and skin perfusion pressure (SPP). Secondary outcomes included IVUS determination of vessel size, wire route, and calcification severity, as well as technical success and clinically-driven target lesion revascularization (TLR), limb salvage, and wound healing rates in the Rutherford category 5/6 patients as evaluated by propensity score matching analysis. Results: The patient and lesion characteristics were similar in both groups. The mean balloon size for IVUS-guided procedures was significantly larger (2.45±0.4 mm) compared with that for angiography-guided procedures (2.23±0.4 mm; p<0.001). The technical success (p=0.56) and complication rates (p=0.16) were similar between the groups. The postprocedure dorsal and plantar SPP and change in dorsal SPP improved more in the IVUS-guided group (p<0.001, p=0.015, and p=0.02, respectively). The IVUS-guided group had a significantly better wound healing rate than the angiography-guided group (p=0.006), although the freedom from TLR and limb salvage rates were similar between the groups (p=0.16 and p>0.99, respectively). Conclusion: IVUS-guided interventions for BTK lesions were safe and effective in accurately assessing the lesions. The results suggest that IVUS guidance of endovascular procedures has the potential to influence better clinical outcomes than angiography-guided angioplasty.
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Affiliation(s)
- Masahiko Fujihara
- Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yuko Yazu
- Department of Medical Engineering, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Honda Y, Araki M, Yamawaki M, Hirano K, Kobayashi N, Sakamoto Y, Mori S, Tsutsumi M, Makino K, Ito Y. The ARAHKEY technique: A novel method for the management of access site bleeding during percutaneous transfemoral transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2019; 96:E355-E359. [PMID: 31815366 DOI: 10.1002/ccd.28610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/12/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This retrospective study assessed the safety and efficacy of the ARAHKEY (ARterial sealing with Additional Hemostatic device Kissing with Extravascular and suture-based device deeplY) technique during transcatheter aortic valve replacement (TAVR). BACKGROUND Access site complications are still a major issue to be solved during TAVR using a large caliber sheath. METHODS From February 2014 to June 2019, a total of 302 patients underwent TAVR in our hospital. Twenty-five patients (10.2% of patients who underwent percutaneous transfemoral TAVR [n = 246]) were treated using the ARAHKEY technique, which is the additional use of Exoseal for the common femoral artery puncture site when hemostasis was not achieved with ProGlide alone. RESULTS Complete hemostasis was achieved in all patients (100%). The mean procedural time for hemostasis was 9.8 ± 4.5 min. No complications, including recurrent bleeding, infection, and late acquired hematoma, were observed in this study cohort. CONCLUSION The ARAHKEY technique is a safe method and should be considered as a secondary option when hemostasis is not achieved with ProGlide during TAVR.
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Affiliation(s)
- Yohsuke Honda
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Motoharu Araki
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Masahiro Yamawaki
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Keisuke Hirano
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Norihiro Kobayashi
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Yasunari Sakamoto
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Shinsuke Mori
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Masakazu Tsutsumi
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Kenji Makino
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
| | - Yoshiaki Ito
- Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Kanagawa, Japan
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10
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Ultrasound Evaluation of Puncture Sites After Deployment of Two Different Types of Vascular Closure Devices: A Prospective Comparative Study. Cardiovasc Intervent Radiol 2018; 41:1654-1663. [DOI: 10.1007/s00270-018-2056-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/07/2018] [Indexed: 12/19/2022]
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11
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Honda Y, Araki M, Yamawaki M, Tokuda T, Tsutumi M, Mori S, Sakamoto Y, Kobayashi N, Hirano K, Ito Y. The novel echo-guided ProGlide technique during percutaneous transfemoral transcatheter aortic valve implantation. J Interv Cardiol 2017; 31:216-222. [DOI: 10.1111/joic.12468] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/12/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- Yohsuke Honda
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Motoharu Araki
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Masahiro Yamawaki
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Takahiro Tokuda
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Masakazu Tsutumi
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Shinsuke Mori
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Yasunari Sakamoto
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Norihiro Kobayashi
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Keisuke Hirano
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
| | - Yoshiaki Ito
- Saiseikai Yokohama City Eastern Hospital; Division of Cardiology; Yokohama Japan
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12
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Lareyre F, Raffort J, Dommerc C, Habib Y, Bourlon F, Mialhe C. Surgical Management of Percutaneous Transfemoral Access to Minimize Vascular Complications Related to Transcatheter Aortic Valve‘ Implantation. Angiology 2017; 69:143-150. [DOI: 10.1177/0003319717711589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Fabien Lareyre
- Cardiovascular Surgery Unit, Cardiothoracic Centre of Monaco, Monaco, France
- University of Côte d’Azur, INSERM, CNRS, IRCAN, Nice, France
| | | | - Carine Dommerc
- Cardiovascular Surgery Unit, Cardiothoracic Centre of Monaco, Monaco, France
| | - Yacoub Habib
- Cardiovascular Surgery Unit, Cardiothoracic Centre of Monaco, Monaco, France
| | - François Bourlon
- Cardiovascular Surgery Unit, Cardiothoracic Centre of Monaco, Monaco, France
| | - Claude Mialhe
- Cardiovascular Surgery Unit, Cardiothoracic Centre of Monaco, Monaco, France
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