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Katapadi A, Pham N, Chelikam N, Ghazal R, Mansabdar A, Ehteshamuddin F, Darden D, Gopinathannair R, Kabra R, Pothineni NV, Bommana S, Atkins D, DiBiase L, Al-Ahmad A, Natale A, Lakkireddy D. Feasibility, safety, and efficacy of a novel external compression vascular closure device: The LockeT® study. J Cardiovasc Electrophysiol 2024. [PMID: 39099135 DOI: 10.1111/jce.16381] [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: 05/20/2024] [Revised: 07/08/2024] [Accepted: 07/17/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION Hemostasis following large-bore femoral vein access remains a challenge. Manual compression has been the standard of care but requires bedside staff, prolonged bed rest, and longer length of stay. The LockeT is an external compression device that attempts to address these issues while achieving venous hemostasis. OBJECTIVES We evaluate postprocedural hemostasis and vascular closure outcomes after using LockeT following cardiac electrophysiologic procedures. METHODS We performed a single-center, observational study of patients who underwent vascular closure for electrophysiology procedures using LockeT. Postprocedural outcomes were subsequently analyzed. RESULTS We studied 102 patients (N) for whom LockeT was used to close 182 separate vascular access sites (n). Common procedures were atrial fibrillation ablation (56.9%, N = 58) and left atrial appendage occlusion (28.4%, N = 29). Most often, 8-Fr [48.3% (n = 126)], 11-Fr [27.2% (n = 71)], and 8.5-Fr [16.9% (n = 44)] sheaths were used, with an average procedure time of 82.1 ± 29.4 min. Hemostasis was achieved in 97.8% (n = 187) of all LockeT cases. Time to ambulation and discharge were 3.93 ± 1.10 h and 8.1 ± 4.4 h, respectively. No major complications were noted. Postprocedurally, 52% (N = 53) of patients were discharged on the same day. There were no differences in hemostasis (p = .859) or ambulation times (p = .202) between procedure types. CONCLUSION The LockeT can effectively close venous access sites with no major complications.
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Affiliation(s)
| | - Nicholas Pham
- Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA
| | | | - Rachad Ghazal
- Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA
| | | | | | - Douglas Darden
- Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA
| | | | - Rajesh Kabra
- Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA
| | | | | | - Donita Atkins
- Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA
| | - Luigi DiBiase
- Department of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, Austin, Texas, USA
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, Austin, Texas, USA
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SUN JN, DONG H, CHEN P, LI ZQ, SUI LY, QI B, JING QM. How to manage the malposition of deep vein catheterization into the artery? J Geriatr Cardiol 2024; 21:682-685. [PMID: 38973825 PMCID: PMC11224658 DOI: 10.26599/1671-5411.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Affiliation(s)
- Jun-Na SUN
- Department of Cardiovascular Diseases, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Hai DONG
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Peng CHEN
- Department of Cardiovascular Diseases, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Zi-Qi LI
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Li-You SUI
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Bin QI
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Quan-Min JING
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
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Barton C, Ganesh J, Sharma V, Lin Z. Protocol-based removal of intra-aortic balloon pump using bioabsorbable anchor/collagen-based vascular closure device following cardiac surgery. JTCVS Tech 2023; 20:92-95. [PMID: 37555050 PMCID: PMC10405165 DOI: 10.1016/j.xjtc.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/05/2023] [Accepted: 04/22/2023] [Indexed: 08/10/2023] Open
Affiliation(s)
- Calum Barton
- Waikato District Health Board, Hamilton, New Zealand
| | | | - Varun Sharma
- Waikato District Health Board, Hamilton, New Zealand
| | - Zaw Lin
- Waikato District Health Board, Hamilton, New Zealand
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An Update on the Clinical Efficacy and Safety of Collagen Injectables for Aesthetic and Regenerative Medicine Applications. Polymers (Basel) 2023; 15:polym15041020. [PMID: 36850304 PMCID: PMC9963981 DOI: 10.3390/polym15041020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/19/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Soft tissues diseases significantly affect patients quality of life and usually require targeted, costly and sometimes constant interventions. With the average lifetime increase, a proportional increase of age-related soft tissues diseases has been witnessed. Due to this, the last two decades have seen a tremendous demand for minimally invasive one-step resolutive procedures. Intensive scientific and industrial research has led to the recognition of injectable formulations as a new advantageous approach in the management of complex diseases that are challenging to treat with conventional strategies. Among them, collagen-based products are revealed to be one of the most promising among bioactive biomaterials-based formulations. Collagen is the most abundant structural protein of vertebrate connective tissues and, because of its structural and non-structural role, is one of the most widely used multifunctional biomaterials in the health-related sectors, including medical care and cosmetics. Indeed, collagen-based formulations are historically considered as the "gold standard" and from 1981 have been paving the way for the development of a new generation of fillers. A huge number of collagen-based injectable products have been approved worldwide for clinical use and have routinely been introduced in many clinical settings for both aesthetic and regenerative surgery. In this context, this review article aims to be an update on the clinical outcomes of approved collagen-based injectables for both aesthetic and regenerative medicine of the last 20 years with an in-depth focus on their safety and effectiveness for the treatment of diseases of the integumental, gastrointestinal, musculoskeletal, and urogenital apparatus.
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Silverberg D, Hater H, Halak M. Rise in Percutaneous Vascular Procedures and Extracorporeal Membrane Oxygenation Is Associated With Increase in Emergent Vascular Operations. Vasc Endovascular Surg 2022; 57:53-59. [PMID: 36165401 DOI: 10.1177/15385744221110433] [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: 11/15/2022]
Abstract
Background: The workload of vascular surgeons is widely affected by the procedural activity of other departments within the same medical center. The purpose of this study was to evaluate the trend in emergent vascular surgery procedures over a 5 year period in a tertiary referral hospital and categorize these procedures based on the nature of the operative procedure required. Methods: A single center, retrospective review of all emergent surgical operations performed at our tertiary referral hospital between the years 2017-2021. Data collected included types of emergent vascular surgery performed, in addition to procedures performed by the departments of interventional cardiology (IC), interventional radiology (IR), neurointerventional radiology (NIR) and extracorporeal membrane oxygenation (ECMO) at our institution. Results: During the study period were performed a total of 1783 operative procedures (mean 356 ± 26/year). Of those, 485 (27%) were emergent cases. We observed a gradual increase in emergent operative procedures performed from 2017 to 2021 (22% to 34% of all cases, increase of 56%, P<.01). A striking increase was seen with vascular repairs performed for iatrogenic vascular injuries secondary to arterial access complications (47% to 65% of all iatrogenic vascular injuries, increase of 38%). The increase correlated with an increase in activity seen in the departments of IC, IR/NIR and ECMO (15%, 31% and 300%, respectively). Conclusions: An increasing number of emergent surgical procedures performed by our vascular surgery department correlates with the increasing number of endovascular procedures performed by non- vascular services. As these procedures are expected to increase, together with the number of stroke units and ECMO units being created, medical centers must be aware that these may result in a significant increase in the workload of the vascular surgery department in order to deal with complications associated with these procedures.
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Affiliation(s)
- Daniel Silverberg
- The Department of Vascular Surgery, 549269The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel
| | - Haitam Hater
- The Department of Vascular Surgery, 549269The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel
| | - Moshe Halak
- The Department of Vascular Surgery, 549269The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel
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Hemostasis control after femoral percutaneous approach: A systematic review and meta-analysis. Int J Nurs Stud 2022; 137:104364. [DOI: 10.1016/j.ijnurstu.2022.104364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 08/26/2022] [Accepted: 09/15/2022] [Indexed: 11/19/2022]
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Regnard O, Regnard S. Management of peripheral vascular interventions in an ambulatory setting: a single center retrospective analysis. Ann Vasc Surg 2022; 85:175-182. [DOI: 10.1016/j.avsg.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/08/2022] [Accepted: 02/13/2022] [Indexed: 11/17/2022]
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Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial. Cardiovasc Intervent Radiol 2020; 44:689-697. [PMID: 33367944 PMCID: PMC8060188 DOI: 10.1007/s00270-020-02738-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/02/2020] [Indexed: 12/24/2022]
Abstract
Purpose Ambulatory peripheral vascular interventions have been steadily increasing. In ambulatory procedures, 4F devices might be particularly useful having the potential to reduce access-site complications; however, further evidence on their safety and efficacy is needed. Materials and Methods BIO4AMB is a prospective, non-randomized mulitcentre, non-inferiority trial conducted in 35 centres in Europe and Australia comparing the use of 4F- and 6F-compatible devices. The main exclusion criteria included an American Society of Anaesthesiologists class ≥ 4, coagulation disorders, or social isolation. The primary endpoint was access-site complications within 30 days. Results The 4F group enrolled 390 patients and the 6F group 404 patients. Baseline characteristics were similar between the groups. Vascular closure devices were used in 7.7% (4F group) and 87.6% (6F group) of patients. Patients with vascular closure device use in the 4F group were subsequently excluded from the primary analysis, resulting in 361 patients in the 4F group. Time to haemostasis was longer for the 4F group, but the total procedure time was shorter (13.2 ± 18.8 vs. 6.4 ± 8.9 min, p < 0.0001, and 39.1 ± 25.2 vs. 46.4 ± 27.6 min, p < 0.0001). Discharge on the day of the procedure was possible in 95.0% (4F group) and 94.6% (6F group) of patients. Access-site complications were similar between the groups (2.8% and 3.2%) and included predominantly groin haematomas and pseudoaneurysms. Major adverse events through 30 days occurred in 1.7% and 2.0%, respectively. Conclusions Ambulatory peripheral vascular interventions are feasible and safe. The use of 4F devices resulted in similar outcomes compared to that of 6F devices. Supplementary Information The online version of this article (10.1007/s00270-020-02738-5) contains supplementary material, which is available to authorized users.
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Allard J, Ghazanfari S, Mahmoudi M, Labreuche J, Escalard S, Delvoye F, Ciccio G, Smajda S, Redjem H, Hebert S, Consoli A, Costalat V, Desilles JP, Mazighi M, Piotin M, Dargazanli C, Lapergue B, Blanc R, Maïer B. Rescue carotid puncture for ischemic stroke treated by endovascular therapy: a multicentric analysis and systematic review. J Neurointerv Surg 2020; 13:809-815. [PMID: 33077577 DOI: 10.1136/neurintsurg-2020-016725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Endovascular therapy (EVT) for acute ischemic stroke (AIS) can be challenging in older patients with supra-aortic tortuosity. Rescue carotid puncture (RCP) can be an alternative in case of supra-aortic catheterization failure by femoral access, but data regarding RCP are scarce. We sought to investigate the feasibility, effectiveness and safety of RCP for AIS treated by EVT. METHODS Patients treated by EVT with RCP were included from January 2012 to December 2019 in the Endovascular Treatment in Ischemic Stroke (ETIS) multicentric registry. Main outcomes included reperfusion rates ( ≥ TICI2B), 3 month functional outcome (modified Rankin Scale) and 3 month mortality. We also performed an additional systematic review of the literature according to the PRISMA checklist to summarize previous studies on RCP. RESULTS 25 patients treated by EVT with RCP were included from the ETIS registry. RCP mainly concerned elderly patients (median age 85 years, range 73-92) with supra-aortic tortuosity (n=16 (64%)). Intravenous thrombolysis (IVT) was used for nine patients (36%). Successful reperfusion was achieved in 64%, 87.5% of patients were dependent at 3 months, and 3 month mortality was 45.8%. The systematic review yielded comparable results. In pooled individual data, there was a shift toward better functional outcome in patients with successful reperfusion (median (IQR) 4 (2-6) vs 6 (4-6), p=0.011). CONCLUSION RCP mainly concerned elderly patients admitted for AIS with anterior LVO with supra-aortic tortuosity. The procedure seemed feasible, notably for patients treated with IVT, and led to significant reperfusion rates at the end of procedure, but with pronounced unfavorable outcomes at 3 months. RCP should be performed under general anesthesia to avoid life-threatening complications and ensure airways safety. Finally, RCP led to low rates of closure complications, emphasizing that this concern should not withhold RCP, if indicated.
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Affiliation(s)
- Julien Allard
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Sam Ghazanfari
- Stroke Center, Hôpital Foch, Suresnes, Île-de-France, France
| | - Mehdi Mahmoudi
- Neuroradiology, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, Languedoc-Roussillon, France
| | - Julien Labreuche
- ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille University Hospital Center, Lille, Hauts-de-France, France
| | - Simon Escalard
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - François Delvoye
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Gabriele Ciccio
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Stanislas Smajda
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Hocine Redjem
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Solène Hebert
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Arturo Consoli
- Neuroradiology, Hopital Foch, Suresnes, Île-de-France, France
| | - Vincent Costalat
- Department of Neuroradiology, University Hospital Centre Montpellier, Montpellier, Occitanie, France
| | - Jean-Philippe Desilles
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France.,Université de Paris, Paris, France.,Laboratory of Vascular Translational Science, U1148, Paris, France
| | - Mikael Mazighi
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France.,Université de Paris, Paris, France.,Laboratory of Vascular Translational Science, U1148, Paris, France
| | - Michel Piotin
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France.,Laboratory of Vascular Translational Science, U1148, Paris, France
| | - Cyril Dargazanli
- Department of Neuroradiology, University Hospital Centre Montpellier, Montpellier, Occitanie, France
| | | | - Raphaël Blanc
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | - Benjamin Maïer
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France.,Université de Paris, Paris, France.,Laboratory of Vascular Translational Science, U1148, Paris, France
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Fataftah J, Tayyem R, Ghosheh B, Tayyem F, Al-Omari M. Endovascular Management of Superficial Femoral Artery Occlusion Secondary to Embolization of Celt ACD® Vascular Closure Device. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e925575. [PMID: 32853183 PMCID: PMC7476740 DOI: 10.12659/ajcr.925575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patient: Male, 70-year-old Final Diagnosis: Embolization of vascular closure device Symptoms: Claudication Medication: — Clinical Procedure: Angioplasty Specialty: Radiology
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Affiliation(s)
- Jehad Fataftah
- Department of Radiology, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Raed Tayyem
- Department of Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Bashar Ghosheh
- Department of Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Farah Tayyem
- Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Mamoon Al-Omari
- Department of Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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12
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Natale A, Mohanty S, Liu PY, Mittal S, Al-Ahmad A, De Lurgio DB, Horton R, Spear W, Bailey S, Bunch J, Musat D, O'Neill P, Compton S, Turakhia MP. Venous Vascular Closure System Versus Manual Compression Following Multiple Access Electrophysiology Procedures: The AMBULATE Trial. JACC Clin Electrophysiol 2019; 6:111-124. [PMID: 31971899 DOI: 10.1016/j.jacep.2019.08.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study compared the efficacy and safety of the VASCADE MVP Venous Vascular Closure System (VVCS) device (Cardiva Medical, Santa Clara, California) to manual compression (MC) for closing multiple access sites after catheter-based electrophysiology procedures. BACKGROUND The VASCADE MVP VVCS is designed to provide earlier ambulatory hemostasis than MC after catheter-based procedures. METHODS The AMBULATE (A Randomized, Multi-center Trial to Compare Cardiva Mid-Bore [VASCADE MVP] VVCS to Manual Compression in Closure of Multiple Femoral Venous Access Sites in 6 - 12 Fr Sheath Sizes) trial was a multicenter, randomized trial of device closure versus MC in patients who underwent ablation. Outcomes included time to ambulation (TTA), total post-procedure time (TPPT), time to discharge eligibility (TTDe), time to hemostasis (TTH), 30-day major and minor complications, pain medication usage, and patient-reported outcomes. RESULTS A total of 204 patients at 13 sites were randomized to the device arm (n = 100; 369 access sites) or the MC arm (n = 104; 382 access sites). Baseline characteristics were similar between groups. Mean TTA, TPPT, TTDe, and TTH were substantially lower in the device arm (respective decreases of 54%, 54%, 52%, and 55%; all p < 0.0001). Opioid use was reduced by 58% (p = 0.001). There were no major access site complications. Incidence of minor complications was 1.0% for the device arm and 2.4% for the MC arm (p = 0.45). Patient satisfaction scores with duration of and comfort during bedrest were 63% and 36% higher in device group (both p < 0.0001). Satisfaction with bedrest pain was 25% higher (p = 0.001) for the device overall, and 40% higher (p = 0.002) for patients with a previous ablation. CONCLUSIONS Use of the closure device for multiple access ablation procedures resulted in significant reductions in TTA, TPPT, TTH, TTDe, and opioid use, with increased patient satisfaction and no increase in complications. (A Randomized, Multi-center Trial to Compare Cardiva Mid-Bore VVCS to Manual Compression in Closure of Multiple Femoral Venous Access Sites in 6 - 12 Fr Sheath Sizes [AMBULATE]; NCT03193021).
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Affiliation(s)
- Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA; Dell Medical School, University of Texas, Austin, Texas, USA; Case Western Reserve University, Cleveland, Ohio, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, California, USA
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA; Dell Medical School, University of Texas, Austin, Texas, USA
| | - P Y Liu
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Suneet Mittal
- Valley Health System and the Snyder Center for Comprehensive Atrial Fibrillation, Ridgewood, New Jersey, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | | | - Rodney Horton
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - William Spear
- Advocate Christ Medical Center, Oak Lawn, Illinois, USA
| | - Shane Bailey
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Jared Bunch
- Intermountain Medical Center, Salt Lake City, Utah, USA
| | - Dan Musat
- Valley Health System and the Snyder Center for Comprehensive Atrial Fibrillation, Ridgewood, New Jersey, USA
| | | | - Steven Compton
- Alaska Heart and Vascular Institute, Anchorage, Alaska, USA
| | - Mintu P Turakhia
- Stanford University, Stanford, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA.
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Faraj J, Choudhary A, Ritter JC. Covered Stenting as Bail-Out Technique for Central Venous Catheter Malposition Within the Brachiocephalic Trunk. Vasc Endovascular Surg 2019; 54:65-68. [DOI: 10.1177/1538574419873175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Central venous catheter (CVC) insertion with ultrasound guidance is routine clinical practice in the critically ill patient. Arterial malposition is serious and may lead to severe complications such as hemorrhage, stroke, or death. We describe a bail-out technique for removal of right-sided CVC that was mispositioned into the brachiocephalic trunk (BCT) at the origin of the right common carotid artery (CCA). Covered stenting of the BCT extending into the CCA in combination with plug embolization of the right subclavian artery was utilized.
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Affiliation(s)
- Joseph Faraj
- Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Anwar Choudhary
- Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jens C. Ritter
- Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
- School of Medicine, Curtin University, Perth, Western Australia, Australia
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Hmoud H, Sturla M, Delucia L, DeGregorio L, DeGregorio J. Closure of mid-bore venotomies with VASCADE VCD after right and left heart catheterization. Catheter Cardiovasc Interv 2019; 93:626-630. [PMID: 30280486 DOI: 10.1002/ccd.27886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/26/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This single-center, retrospective analysis investigated the clinical outcomes of a novel vascular closure device (VASCADE, Cardiva Medical, Santa Clara, CA) for closure of 7F femoral venotomies. BACKGROUND The VASCADE closure device has been widely used to close arteriotomy sites following femoral procedures; however, little data have been published regarding the device's utility in closure of venotomy sites after procedures such as right-heart catheterization. METHODS This was a retrospective analysis of outcomes in 102 consecutive patients who underwent venous closure using the VASCADE device following diagnostic right and left-heart catheterization between April 2016 to May 2018. Patients' age, gender, valvular disease status, comorbidities, and periprocedural use of antiplatelet/anticoagulant therapy were analyzed. RESULTS Closure was successful in 99% (101/102) of patients with respect to achieving the primary outcome of rapid hemostasis in ≤3 min. There was one device failure requiring manual compression, with no further complications. There were no other related adverse events or complications through 30 days of follow-up. CONCLUSIONS The VASCADE device achieved venous hemostasis in nearly all our patients. We believe devices for venous closure can aid in improving patient experience, safety, and efficiency during these procedures.
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Affiliation(s)
- Hosam Hmoud
- St. George's University School of Medicine, West Indies, Grenada
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Hall TC, Habib S. A Novel Intervention to Treat Failed Angio-Seal Footplate Deployment: Two Case Series. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2019; 12:1179547619828714. [PMID: 30792582 PMCID: PMC6376524 DOI: 10.1177/1179547619828714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 01/14/2019] [Indexed: 11/15/2022]
Abstract
Introduction Vascular closure devices are commonly used to achieve rapid haemostasis and early ambulation following arterial puncture for endovascular procedures. Although device failure rates are low, the consequences of arterial occlusion include severe limb ischaemia. We describe a novel endovascular technique for the treatment of Angio-Seal arterial closure device (Terumo, Europe NV) failure causing femoral artery occlusion. Materials and methods We describe 2 cases of lower limb angioplasty performed for critical limb ischaemia where the access site was closed using an Angio-Seal according to the manufacturer instructions for use (IFU). In both cases, however, ultrasound could not be used during deployment of the Angio-Seal due to body habitus and small subcutaneous haematoma. In both cases, the device failed and occluded the femoral artery. Results Access was achieved via a retrograde approach from the contralateral limb in one case and a retrograde approach from the ipsilateral profunda artery in the other case. Angiography confirmed that the footplate of the Angio-Seal had occluded the femoral artery. Subsequently, the occlusion was crossed and a short balloon-mounted bare metal stent placed to push the footplate against the arterial wall that resulted in resolution of the occlusion and haemorrhage control. Conclusions Crossing the occlusion caused by failure of the Angio-Seal closure device and subsequent stenting resulted in satisfactory relief of the femoral artery occlusion and haemostasis without the added risks of open surgical revascularisation and general anaesthetic.
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Affiliation(s)
- Thomas C Hall
- Department of Radiology, Queen's Medical Centre (QMC), Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Said Habib
- Department of Radiology, Queen's Medical Centre (QMC), Nottingham University Hospitals NHS Trust, Nottingham, UK
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Tonetti DA, Ferari C, Perez J, Ozpinar A, Jadhav AP, Jovin TG, Gross BA, Jankowitz BT. Validation of an extrinsic compression and early ambulation protocol after diagnostic transfemoral cerebral angiography: a 5-year prospective series. J Neurointerv Surg 2019; 11:837-840. [DOI: 10.1136/neurintsurg-2018-014572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 11/04/2022]
Abstract
Background and purposeAccess-site complications constitute a substantial portion of the morbidity associated with transfemoral cerebral angiography, yet no standardized protocol exists for femoral closure and practice patterns vary widely. The objective of this single-arm prospective cohort study was to validate the efficacy and safety of a standardized femoral closure strategy for all diagnostic angiography, regardless of antiplatelet regimen.MethodsA single-arm, prospective study was designed enrolling consecutive patients undergoing diagnostic transfemoral cerebral angiography by a single neurointerventional surgeon from March 2013 – March 2018. The closure protocol consisted of 20 minutes of manual compression to the site of arterial access and 2 hours of bedrest. The primary outcome was hematoma or oozing after manual compression. Demographic, clinic, and laboratory data were collected and analyzed, and patients were stratified by antiplatelet use.ResultsOf 525 angiograms, 263 (50.1%) were on patients taking antiplatelet medication, with 66 (12.6%) on dual antiplatelet regimens. Five patients (0.95% of all patients) met the primary outcome: in all five cases, there was no further oozing or enlarging hematoma after the additional compression period. There were not significant differences in primary outcome in groups stratified by antiplatelet use, and there were no instances of delayed hematoma, pseudoaneurysm, or arteriovenous fistula.ConclusionIn this single-arm cohort study of 525 consecutive transfemoral angiograms with a standardized extrinsic compression protocol, hemostasis was achieved without complication in >99% regardless of antiplatelet strategy. This protocol is effective and safe for diagnostic transfemoral angiography regardless of a patient’s antiplatelet use.
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Aljarrah Q, Al-Omari M, Qader K, Oweis J, Althaher A. Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk. CVIR Endovasc 2018; 1:4. [PMID: 30652137 PMCID: PMC6319502 DOI: 10.1186/s42155-018-0013-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background This report presents a case of surgical retrieval of a Celt ACD® vascular closure device (VCD) situated in the tibioperoneal trunk, following a failed attempt at deployment. Existing literature mostly recommends an endovascular approach when attempting to retrieve embolised VCDs. Case presentation A 55 year old male presented with right sudden right lower limb pain and numbness 1 week following a successful left retrograde superficial femoral artery (SFA) angioplasty. Computed tomography (CT) angiogram revealed that the Celt ACD® VCD had embolised in the right tibioperoneal trunk. An endovascular approach was initially attempted to retrieve the VCD; however, this was unsuccessful due to the small diameter of the target artery. Due to the failure of the endovascular approach, surgical exploration of the right tibioperoneal trunk was undertaken, which led to the successful retrieval of the embolised VCD. Conclusion The case presented herein demonstrates the critical need for swift and decisive surgical exploration of patients with suspected embolisation of Celt ACD® devices in smaller distal arteries. Our experience has led to the recommendation that, due to the sharp edges of the Celt ACD® accompanied with the small diameter of the occluded vessels, surgical exposure and retrieval is the safest option if endovascular retrieval is unsuccessful.
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Affiliation(s)
- Qusai Aljarrah
- 1Vascular Surgery, Jordan University of Science and Technology, Irbid, Jordan
| | - Ma'moon Al-Omari
- 2Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Jozef Oweis
- 4Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmad Althaher
- 4Jordan University of Science and Technology, Irbid, Jordan
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Jones LE, Yang KH, Feldtman RW, Uceda PV, Ferrara CA, Caruso JM, Richmond JL, Ahn SS. Safety and Efficacy of Arterial Closure Devices in an Office-Based Angiosuite. Ann Vasc Surg 2018; 51:10-17. [DOI: 10.1016/j.avsg.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/11/2018] [Accepted: 02/19/2018] [Indexed: 12/20/2022]
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Su SF, Chang MY, Wu MS, Liao YC. Safety and efficacy of using vascular closure devices for hemostasis on sheath removal after a transfemoral artery percutaneous coronary intervention. Jpn J Nurs Sci 2018; 16:172-183. [PMID: 30044037 DOI: 10.1111/jjns.12221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 04/18/2018] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
Abstract
AIM To determine the efficacy of vascular closure devices (VCDs) for hemostasis following transfemoral percutaneous coronary interventions (PCIs). METHODS This two-group pre-post-test observational study with purposive sampling enrolled 73 patients between January, 2014 and February, 2015. The patients were allocated to either the intervention (vascular closure devices group, n = 34) or the control group (manual compression [MC] group, n = 39). Questionnaires were used to assess their demographic and clinical characteristics, vascular complications, visual analogue scale score for pain, and discomfort levels. Pain and discomfort were measured before and after the PCI. RESULTS Vascular complications were observed in 15 (44.1%) VCD patients and 13 (33.3%) MC patients, with no significant between-group difference. However, the VCD patients had a higher relative risk of bruising, hematomas, and need for further treatment. After the PCI, the pain scores and discomfort levels increased significantly in both groups, but the VCD patients had more successful hemostasis, less pain, and less physical and psychological discomfort (lower-limb numbness, shoulder pain, restlessness, and worrying about walking ability, being unable to lift heavy objects in the future, and taking time off from work). CONCLUSION The VCDs seem to be superior to the MCs, providing more successful hemostasis, less pain and discomfort, and earlier ambulation after a transfemoral PCI. These findings aid clinical nurses in understanding the risk of vascular complications, discomfort, and pain that are associated with VCD use for improving the quality of clinical care and help clinicians in determining the appropriate hemostatic method for patients undergoing a transfemoral PCI, particularly in the Chinese population.
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Affiliation(s)
- Shu-Fen Su
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Mei-Yu Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Meng-Shan Wu
- Department of Nursing, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Ying-Chin Liao
- Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Fuxing Township, Taiwan
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Scott MC, Spencer HJ, Ali AT, Moursi MM, Escobar GA, Lyons LC, Smeds MR. Mynx Vascular Closure Device in Arterial Endovascular Procedures. Ann Vasc Surg 2018; 46:112-117. [DOI: 10.1016/j.avsg.2017.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 11/24/2022]
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Klein-Wiele O, Baliota M, Kara K, Käunicke M, Schäfer H, Garbrecht M, Abdulghafor M, Garmer M, Hailer B. Safety and efficacy of clip-based vs. suture mediated vascular closure for femoral access hemostasis: A prospective randomized single center study comparing the StarClose and the ProGlide device. Catheter Cardiovasc Interv 2017; 91:402-407. [DOI: 10.1002/ccd.27116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/27/2017] [Accepted: 04/08/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Oliver Klein-Wiele
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
| | - Maria Baliota
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
| | - Kaffer Kara
- Department of Cardiology; Cardiovascular Centre, Josef Hospital, Gudrunstr. 56, University of Bochum; Bochum Germany
| | - Matthias Käunicke
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
| | - Harald Schäfer
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
| | - Marc Garbrecht
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
| | - Marwan Abdulghafor
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
| | - Marietta Garmer
- Department of Radiology; University of Witten/Herdecke, Grönemeyer Institut Bochum, Universitätsstraße 142; 44799 Bochum Germany
| | - Birgit Hailer
- Department of Cardiology; University of Witten/Herdecke, Katholisches Klinikum Essen, Hülsmannstraße 17; 45355 Essen Germany
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Babaev A, Gokhale R, Zavlunova S, Attubato M. Treatment of Angio-Seal-Related Femoral Artery Occlusion Using Directional Atherectomy-Primary Results and Midterm Follow-Up. Vasc Endovascular Surg 2016; 50:541-546. [PMID: 27852881 DOI: 10.1177/1538574416679520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We describe a novel approach for the endovascular treatment of femoral artery occlusion as a result of Angio-Seal closure device deployment. BACKGROUND Angio-Seal is the most commonly used vascular closure device following percutaneous coronary and peripheral catheterizations worldwide. A rare complication of Angio-Seal deployment is an occlusion of the femoral artery leading to limb ischemia requiring revascularization. Given its unique ability to cut both atherosclerotic plaque and the Angio-Seal anchor with a collagen plug at operator-directed planes, TurboHawk/HawkOne atherectomy device can be a fast and effective approach to treat Angio-Seal-associated femoral artery occlusions. METHODS We studied 13 consecutive patients who developed Angio-Seal-associated femoral artery occlusions that occurred from 3 hours to several weeks after catheterization. These patients were successfully treated with TurboHawk/HawkOne directional atherectomy followed by balloon angioplasty with no complications. During a mean follow-up period of 20.4 ± 17.3 months, 12 patients remained claudication free with no evidence of obstructive arterial disease of the treated segment on imaging studies. One patient developed restenosis that was treated with repeat atherectomy and balloon angioplasty following which he was asymptomatic at follow-up. CONCLUSION The use of directional atherectomy followed by balloon angioplasty is a quick, safe, and effective endovascular approach to treating Angio-Seal-associated femoral artery occlusions. It is associated with an excellent success rate, no complications, and good midterm outcomes.
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Affiliation(s)
- Anvar Babaev
- 1 Division of Cardiology, Department of Medicine, New York University, NY, USA
| | - Rohit Gokhale
- 1 Division of Cardiology, Department of Medicine, New York University, NY, USA
| | - Susanna Zavlunova
- 1 Division of Cardiology, Department of Medicine, New York University, NY, USA
| | - Michael Attubato
- 1 Division of Cardiology, Department of Medicine, New York University, NY, USA
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Vinayakumar D, Kayakkal S, Rajasekharan S, Thottian JJ, Sankaran P, Bastian C. 24h and 30 day outcome of Perclose Proglide suture mediated vascular closure device: An Indian experience. Indian Heart J 2016; 69:37-42. [PMID: 28228304 PMCID: PMC5319010 DOI: 10.1016/j.ihj.2016.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 06/20/2016] [Accepted: 06/21/2016] [Indexed: 12/17/2022] Open
Abstract
Introduction Advantages of vascular closure device over manual compression include patient comfort, early mobilisation and discharge, avoidance of interruption of anticoagulation, avoidance of local compression and its sequelae and less time constraint on staff. No published Indian data exist regarding Perclose Proglide suture mediated vascular closure device (SMC). Aim To study the 24 h and 30 day outcome of Perclose Proglide SMC retrospectively. Study design Retrospective observational study conducted in the Department of Cardiology, Government Medical College, Calicut, Kerala from June 2013 to June 2015. Methodology All consecutive patients with Perclose Proglide SMC deployment done by a single operator for achieving access site haemostasis where 24 h and 30 day post-procedure data were available were included. Major and minor complications, procedure success, device failure were predefined. Results 323 patients were analysed. Procedure success rate was 99.7% (322/323). Transient oozing occurred in 44 patients (13.6%), minor and major complications occurred in 2% and 1.5% of patients respectively. Major complication included one case of retroperitoneal bleed, one access site infection, one pseudo aneurysm formation and two access site arterial stenosis. There was no death or complication requiring limb amputation. “Preclose” technique was used successfully in six patients. Primary device failure occurred in 12 cases which were tackled successfully with second Proglide in all except one. Conclusion Perclose Proglide SMC is a safe and effective method to achieve haemostasis up to 22F with less complication rate.
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Affiliation(s)
- Desabandhu Vinayakumar
- Additional Professor, Department of Cardiology, Government Medical College, Calicut, Kerala, India
| | - Shajudeen Kayakkal
- Senior Resident, Department of Cardiology, Government Medical College, Calicut, Kerala, India.
| | - Sandeep Rajasekharan
- Senior Resident, Department of Cardiology, Government Medical College, Calicut, Kerala, India
| | - Julian Johny Thottian
- Senior Resident, Department of Cardiology, Government Medical College, Calicut, Kerala, India
| | - Prasanth Sankaran
- Senior Resident, Department of Cardiology, Government Medical College, Calicut, Kerala, India
| | - Cicy Bastian
- Additional Professor, Department of Cardiology, Government Medical College, Calicut, Kerala, India
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Robertson L, Andras A, Colgan F, Jackson R. Vascular closure devices for femoral arterial puncture site haemostasis. Cochrane Database Syst Rev 2016; 3:CD009541. [PMID: 26948236 PMCID: PMC10372718 DOI: 10.1002/14651858.cd009541.pub2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Vascular closure devices (VCDs) are widely used to achieve haemostasis after procedures requiring percutaneous common femoral artery (CFA) puncture. There is no consensus regarding the benefits of VCDs, including potential reduction in procedure time, length of hospital stay or time to patient ambulation. No robust evidence exists that VCDs reduce the incidence of puncture site complications compared with haemostasis achieved through extrinsic (manual or mechanical) compression. OBJECTIVES To determine the efficacy and safety of VCDs versus traditional methods of extrinsic compression in achieving haemostasis after retrograde and antegrade percutaneous arterial puncture of the CFA. SEARCH METHODS The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (April 2015) and the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 3). Clinical trials databases were searched for details of ongoing or unpublished studies. References of articles retrieved by electronic searches were searched for additional citations. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials in which people undergoing a diagnostic or interventional procedure via percutaneous CFA puncture were randomised to one type of VCD versus extrinsic compression or another type of VCD. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed the methodological quality of trials. We resolved disagreements by discussion with the third author. We performed meta-analyses when heterogeneity (I(2)) was < 90%. The primary efficacy outcomes were time to haemostasis and time to mobilisation (mean difference (MD) and 95% confidence interval (CI)). The primary safety outcome was a major adverse event (mortality and vascular injury requiring repair) (odds ratio (OR) and 95% CI). Secondary outcomes included adverse events. MAIN RESULTS We included 52 studies (19,192 participants) in the review. We found studies comparing VCDs with extrinsic compression (sheath size ≤ 9 Fr), different VCDs with each other after endovascular (EVAR) and percutaneous EVAR procedures and VCDs with surgical closure after open exposure of the artery (sheath size ≥ 10 Fr). For primary outcomes, we assigned the quality of evidence according to GRADE (Grades of Recommendation, Assessment, Development and Evaluation) criteria as low because of serious imprecision and for secondary outcomes as moderate for precision, consistency and directness.For time to haemostasis, studies comparing collagen-based VCDs and extrinsic compression were too heterogenous to be combined. However, both metal clip-based (MD -14.81 minutes, 95% CI -16.98 to -12.63 minutes; five studies; 1665 participants) and suture-based VCDs (MD -14.58 minutes, 95% CI -16.85 to -12.32 minutes; seven studies; 1664 participants) were associated with reduced time to haemostasis when compared with extrinsic compression.For time to mobilisation, studies comparing collagen-, metal clip- and suture-based devices with extrinsic compression were too heterogeneous to be combined. No deaths were reported in the studies comparing collagen-based, metal clip-based or suture-based VCDs with extrinsic compression. For vascular injury requiring repair, meta-analyses demonstrated that neither collagen (OR 2.81, 95% CI 0.47 to 16.79; six studies; 5731 participants) nor metal clip-based VCDs (OR 0.49, 95% CI 0.03 to 7.95; three studies; 783 participants) were more effective than extrinsic compression. No cases of vascular injury required repair in the study testing suture-based VCD with extrinsic compression.Investigators reported no differences in the incidence of infection between collagen-based (OR 2.14, 95% CI 0.88 to 5.22; nine studies; 7616 participants) or suture-based VCDs (OR 1.66, 95% CI 0.22 to 12.71; three studies; 750 participants) and extrinsic compression. No cases of infection were observed in studies testing suture-based VCD versus extrinsic compression. The incidence of groin haematoma was lower with collagen-based VCDs than with extrinsic compression (OR 0.46, 95% CI 0.40 to 0.54; 25 studies; 10,247 participants), but no difference was evident when metal clip-based (OR 0.79, 95% CI 0.46 to 1.34; four studies; 1523 participants) or suture-based VCDs (OR 0.65, 95% CI 0.41 to 1.02; six studies; 1350 participants) were compared with extrinsic compression. The incidence of pseudoaneurysm was lower with collagen-based devices than with extrinsic compression (OR 0.74, 95% CI 0.55 to 0.99; 21 studies; 9342 participants), but no difference was noted when metal clip-based (OR 0.76, 95% CI 0.20 to 2.89; six studies; 1966 participants) or suture-based VCDs (OR 0.79, 95% CI 0.25 to 2.53; six studies; 1527 participants) were compared with extrinsic compression. For other adverse events, researchers reported no differences between collagen-based, clip-based or suture-based VCDs and extrinsic compression.Limited data were obtained when VCDs were compared with each other. Results of one study showed that metal clip-based VCDs were associated with shorter time to haemostasis (MD -2.24 minutes, 95% CI -2.54 to -1.94 minutes; 469 participants) and shorter time to mobilisation (MD -0.30 hours, 95% CI -0.59 to -0.01 hours; 469 participants) than suture-based devices. Few studies measured (major) adverse events, and those that did found no cases or no differences between VCDs.Percutaneous EVAR procedures revealed no differences in time to haemostasis (MD -3.20 minutes, 95% CI -10.23 to 3.83 minutes; one study; 101 participants), time to mobilisation (MD 1.00 hours, 95% CI -2.20 to 4.20 hours; one study; 101 participants) or major adverse events between PerClose and ProGlide. When compared with sutures after open exposure, VCD was associated with shorter time to haemostasis (MD -11.58 minutes, 95% CI -18.85 to -4.31 minutes; one study; 151 participants) but no difference in time to mobilisation (MD -2.50 hours, 95% CI -7.21 to 2.21 hours; one study; 151 participants) or incidence of major adverse events. AUTHORS' CONCLUSIONS For time to haemostasis, studies comparing collagen-based VCDs and extrinsic compression were too heterogeneous to be combined. However, both metal clip-based and suture-based VCDs were associated with reduced time to haemostasis when compared with extrinsic compression. For time to mobilisation, studies comparing VCDs with extrinsic compression were too heterogeneous to be combined. No difference was demonstrated in the incidence of vascular injury or mortality when VCDs were compared with extrinsic compression. No difference was demonstrated in the efficacy or safety of VCDs with different mechanisms of action. Further work is necessary to evaluate the efficacy of devices currently in use and to compare these with one other and extrinsic compression with respect to clearly defined outcome measures.
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Affiliation(s)
- Lindsay Robertson
- Freeman HospitalDepartment of Vascular SurgeryNewcastle upon Tyne Hospitals NHS Foundation TrustHigh HeatonNewcastle upon TyneUKNE7 7DN
| | - Alina Andras
- Keele University, Guy Hilton Research CentreInstitute for Science and Technology in MedicineThornburrow DriveHartshillStoke‐on‐TrentUKST4 7QB
- Freeman HospitalNorthern Vascular CentreNewcastle upon TyneUKNE7 7DN
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Behnes M, Ünsal M, Hoffmann U, Fastner C, El-Battrawy I, Lang S, Mashayekhi K, Lehmann R, Borggrefe M, Akin I. Design and Rationale of the Femoral Closure versus Radial Compression Devices Related to Percutaneous Coronary Interventions (FERARI) Study. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 9:97-103. [PMID: 26568686 PMCID: PMC4635979 DOI: 10.4137/cmc.s31932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/23/2015] [Accepted: 08/25/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bleeding events after percutaneous coronary interventions (PCI) are associated with patients’ age, gender, and the presence of chronic kidney disease, antithrombotic treatment, as well as arterial access site. Patients being treated by PCI using radial access site are associated with an improved prognosis. However, the safety of femoral closure devices has never been compared to radial compression devices following PCI. Therefore, the aim of this study is to evaluate the safety of femoral closure compared to radial compression devices in patients treated by PCI envisaging access site bleedings as well as short- and long-term prognostic outcomes. METHODS The Femoral Closure versus Radial Compression Devices Related to Percutaneous Coronary Interventions (FERARI) study is a single-center observational study comparing 400 consecutive patients undergoing PCI either using radial compression devices (TR Band™) or femoral closure devices (Angio-Seal™) at the corresponding access site. The primary outcome consists of the occurrence of vascular complications at the arterial access site, including major bleedings as defined by common classification systems. Secondary outcomes consist of the occurrence of adverse cardiac events, including all-cause mortality, target lesion revascularization, and target vessel revascularization during 30 days and 12 months of follow-up. RESULTS Study enrollment was initiated in February 2014. The enrollment phase is expected to last until May 2015. CONCLUSIONS The FERARI study intends to comparatively evaluate the safety and prognostic outcome of patients being treated by radial or femoral arterial closure devices following PCI during daily clinical practice.
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Affiliation(s)
- Michael Behnes
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Melike Ünsal
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ursula Hoffmann
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Christian Fastner
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ibrahim El-Battrawy
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Siegfried Lang
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Kambis Mashayekhi
- Internal Medicine Clinic II, Helios Vogtland Klinikum Plauen, Academic Teaching Hospital of Leipzig University, Plauen, Germany
| | - Ralf Lehmann
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Martin Borggrefe
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ibrahim Akin
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
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Krishnasamy VP, Hagar MJ, Scher DJ, Sanogo ML, Gabriel GE, Sarin SN. Vascular Closure Devices: Technical Tips, Complications, and Management. Tech Vasc Interv Radiol 2015; 18:100-12. [DOI: 10.1053/j.tvir.2015.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Cuellar H, Guimaraens L, Ambekar S, Vivas E, Theron J. Angioseal™ as a hemostatic device for direct carotid puncture during endovascular procedures. Interv Neuroradiol 2015; 21:273-6. [PMID: 25964438 DOI: 10.1177/1591019915581991] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Direct carotid artery puncture (DCP) is employed in patients with tortuous anatomy and peripheral vascular disease when the peripheral arteries are not available for vascular access. Manual compression is the only method of achieving hemostasis following DCP and, till date, the use of a closure device for DCP has been reported in only one patient. In this study we sought to analyze our experience with the use of closure device for DCP. METHODS This is a retrospective study of patients in whom Angioseal™ was used following DCP for neuroendovascular procedures. Medical charts and imaging of these patients was reviewed for any abnormalities pertaining to the use of the closure device. RESULTS A total of eight patients were included in the study. Angioseal™ was used in all the patients. There were no complications related to the use of the closure device in any of the eight patients. Immediate post-procedure angiography done in one patient did not show any structural or hemodynamic abnormalities within the carotid artery lumen. At 6 months follow-up imaging, there was no evidence stenosis or vascular wall abnormality in any of the patients. There were no adverse clinical reactions related to the use of closure device. CONCLUSION In our experience, Angioseal™ may be a safe and off-label effective closure device for patients undergoing DCP for neuroendovascular procedures. It obviates the need for manual compression without causing any structural or hemodynamic changes within the carotid artery. Larger studies with longer follow-up are required to establish its safety in patients undergoing DCP.
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Affiliation(s)
- Hugo Cuellar
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Leopoldo Guimaraens
- Department of Interventional Neuroradiology, Hospital General de Catalunya, Neuroangiografia Terapeutica, Barcelona, Spain Department of Interventional Neuroradiology, Hospital Nuestra Señora del Rosario, Terapeutica Endovascular y Percutanea, Madrid, Spain
| | - Sudheer Ambekar
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Elio Vivas
- Department of Interventional Neuroradiology, Hospital General de Catalunya, Neuroangiografia Terapeutica, Barcelona, Spain
| | - Jacques Theron
- Department of Interventional Neuroradiology, Hospital Nuestra Señora del Rosario, Terapeutica Endovascular y Percutanea, Madrid, Spain
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Barbetta I, van den Berg JC. Access and hemostasis: femoral and popliteal approaches and closure devices-why, what, when, and how? Semin Intervent Radiol 2014; 31:353-60. [PMID: 25435661 DOI: 10.1055/s-0034-1393972] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This article reviews the arterial access sites used in the treatment of peripheral arterial disease, including common femoral, superficial femoral, and popliteal arterial puncture. The optimal approach and techniques for arterial puncture will be described and technical tips and tricks will be discussed. An overview of the currently available vascular closure devices will also be presented. Indications, contraindications, and complications will be discussed. Results of the use of vascular closure devices compared with manual compression will be presented.
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Affiliation(s)
- Iacopo Barbetta
- Service of Interventional Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Jos C van den Berg
- Service of Interventional Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland
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Mirza AKH, Steerman SN, Ahanchi SS, Higgins JA, Mushti S, Panneton JM. Analysis of vascular closure devices after transbrachial artery access. Vasc Endovascular Surg 2014; 48:466-9. [PMID: 25267690 DOI: 10.1177/1538574414551576] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION We seek to determine whether vascular closure devices (VCDs) are safe and effective for brachial artery access. METHODS A retrospective review of brachial artery access using either manual compression (MC) or a VCD for hemostasis from November 2005 to February 2011 was performed. RESULTS Brachial artery access was performed on 154 limbs: MC on 134 limbs and VCD on 20 limbs. The incidence of thrombotic (VCD n = 0 [0%] vs MC n = 7 [5.2%], P = .37), hemorrhagic complications (VCD n = 1 [5%] vs MC n = 7 [5.2%], P = .72), or major adverse events (VCD n = 1 [5%] vs MC n = 16 [12%], P = .32) was not significantly different between the techniques. After univariate and multivariate analysis, female sex (P = .07, relative risk [RR] = 5.7), sheath size > 6F (P = .008, RR = 14.6), and diagnostic versus interventional procedure (P = .04, RR = 0.4) all impacted the occurrence of thrombosis. CONCLUSIONS Use of VCD in the brachial artery following an endovascular procedure showed equivalence to MC.
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Choo HJ, Jeong HW, Park JY, Jin SC, Kim ST, Seo JH, Lee SJ, Park YM. Ultrasonographic features of vascular closure devices: initial and 6-month follow-up results. Ultrasonography 2014; 33:283-90. [PMID: 25145584 PMCID: PMC4176108 DOI: 10.14366/usg.14023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/20/2014] [Accepted: 07/16/2014] [Indexed: 11/03/2022] Open
Abstract
PURPOSE This study aimed to evaluate the ultrasonographic findings for various types of vascular closure devices (VCDs) immediately after the angiographic procedure and at 6-month follow-up. METHODS We included 18 VCDs including Angio-Seal (n=4), FemoSeal (n=8), ExoSeal (n=3), Perclose (n=2), and StarClose (n=1) in this study. Four patients were implanted with 2 VCDs at the each side of bilateral femoral arteries, while the remaining 8 patients were inserted 1 VCD at the right femoral artery. Ultrasonography was performed within 10 days and at approximately 6 months after the angiographic procedure. Ultrasonographic morphology of the attached VCD and its relationship with the arterial wall were analyzed. RESULTS Initial ultrasonography revealed the attached VCD as the relevant unique structure with successful deployment and hemostasis. Follow-up ultrasonography demonstrated partial absorption of hemostatic materials in cases of Angio-Seal (n=3), FemoSeal (n=5), and ExoSeal (n=3), changes in the soft tissue surrounding the femoral artery in case of Angio-Seal (n=1), arterial intimal hyperplasia in cases of FemoSeal (n=3), and no gross changes as compared with the initial ultrasonographic findings in cases of Perclose (n=2) and StarClose (n=1). CONCLUSION Initial ultrasonographic evaluation reflected the unique structure of each VCD, with most of them being easily distinguishable. Follow-up ultrasonography revealed various changes in the affected vessels.
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Affiliation(s)
- Hye Jung Choo
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hae Woong Jeong
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jin Young Park
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sung-Chul Jin
- Department of Neurosurgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sung Tae Kim
- Departments of Neurosurgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jung Hwa Seo
- Departments of Neurology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sun Joo Lee
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Young Mi Park
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Outcomes after arterial endovascular procedures performed in patients with an elevated international normalized ratio. Ann Vasc Surg 2014; 29:22-7. [PMID: 24930974 DOI: 10.1016/j.avsg.2014.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/17/2014] [Accepted: 05/18/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Patients treated with anticoagulants frequently require urgent vascular procedures and elevated prothrombin time/international normalized ratio (INR) is traditionally thought to increase access site bleeding complications after sheath removal. We aimed to determine the safety of percutaneous arterial procedures on patients with a high INR in the era of modern ultrasound-guided access and closure device use. METHODS Patients undergoing arterial endovascular procedures at a single institution between October 2010 and November 2012 were reviewed (n = 1,333). We retrospectively analyzed all patients with an INR > 1.5. Venous procedures, lysis checks, and cases with no documented INR within 24 hr were excluded. Sixty-five patients with 91 punctures were identified. A comparison group was then generated from the last 91 patients intervened on with INR < 1.6. Demographics, intraoperative data, and postoperative complications were compared. RESULTS The demographics were similar. More Coumadin use and higher INR were found in the study group (71/91 and 0/91, P = 0.001; 2.3 and 1.1 sec, P = 0.001, respectively), but there was more antiplatelet use in the control group (68/91 and 51/91, P = 0.01). Intraoperatively, the sheath sizes, protamine use, closure device use, ultrasound guidance, brachial access, and procedure types were not statistically different. Sheath sizes ranged from 4 to 22F in the study group and 4 to 20F in the control group. Paradoxically, heparin was administered more frequently in the study group (64/91 and 50/91, P = 0.046). Bleeding complications occurred more commonly in the study group (3/91 and 1/91, P = 0.62), but this failed to reach significance and the overall complication rate in both groups was low. CONCLUSIONS Endovascular procedures may be performed safely with a low risk of bleeding complications in patients with an elevated INR. Ultrasound guidance and closure device use may allow these cases to be performed safely, but a larger series may be needed to confirm this.
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Radial artery occlusion after percutaneous coronary interventions - an underestimated issue. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2013; 9:353-61. [PMID: 24570753 PMCID: PMC3927109 DOI: 10.5114/pwki.2013.38865] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/15/2013] [Accepted: 10/30/2013] [Indexed: 12/18/2022] Open
Abstract
The femoral approach is the most common arterial access for percutaneous coronary artery interventions. Despite the convenience and simplicity of this approach, it is burdened with a high risk of arterial puncture bleeding, which worsens the prognosis of the patient. An alternative approach through the radial artery has been gaining more and more popularity in recent years. This is due to a significant reduction of local bleeding complications as compared with the femoral artery approach. The use of the radial approach in patients with ST-segment elevation myocardial infarction improves outcome, reducing the risk of death, subsequent myocardial infarction and stroke, and is the preferred approach according to the latest ESC guidelines. In addition to improving safety, it is beneficial for improving patient comfort, with a shorter recovery after the procedure, shorter hospitalization and lower medical costs. One of the major complications of procedures performed through the radial approach is radial artery occlusion (RAO). Although it usually has an asymptomatic course, RAO eliminates the ability to use the radial artery as an access in the future. A number of factors that contribute to the occurrence of RAO have been identified, such as the size of the sheath and the catheter, diameter ratio of the sheath to the diameter of the radial artery, insufficient anticoagulation and, above all, the way of obtaining hemostasis at the puncture site: the duration of artery compression after sheath removal and the preservation of artery patency during compression (so-called patent hemostasis). This paper presents the current state of the art about the factors that contribute to the occurrence of RAO and methods for preventing this complication.
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Cahill TJ, Choji K, Kardos A. Fluoroscopy-guided snare retrieval of the celt ACD®metallic vascular closure device following failed deployment. Catheter Cardiovasc Interv 2013; 83:556-9. [DOI: 10.1002/ccd.25229] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/09/2013] [Accepted: 09/30/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Thomas J. Cahill
- Department of Cardiology; Milton Keynes Hospital, NHS Foundation Trust; United Kingdom
| | - Kiyoshi Choji
- Department of Radiology; Milton Keynes Hospital, NHS Foundation Trust; United Kingdom
| | - Attila Kardos
- Department of Cardiology; Milton Keynes Hospital, NHS Foundation Trust; United Kingdom
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Gouicem D, Palcau L, Le Hello C, Cameliere L, Dufranc J, Coffin O, Berger L. Feasibility of ambulatory percutaneous femoral access without the use of arterial closure systems. Ann Vasc Surg 2013; 28:132-6. [PMID: 24183456 DOI: 10.1016/j.avsg.2013.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 06/11/2013] [Accepted: 06/12/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND To evaluate the feasibility of early ambulation in patients treated for peripheral occlusive lesions by femoral percutaneous access, without the use of closure systems and the application to ambulatory practice. METHODS This single-center observational exploratory study was undertaken among 99 consecutive patients between August 1-December 31, 2011 (mean age: 72 years; 72 men) who were treated by percutaneous femoral route for peripheral arterial lesions. All the patients had a manual compression then pressure bandage. A clinical evaluation was carried out after 4 hours, seeking a local or a general complication and checking the procedure. Rising and walking in the unit of hospitalization were authorized in the absence of complication as of 4 hours postoperatively. All patients remained in hospital for at least 1 night, with a clinical revaluation before discharge. All patients were contacted by telephone at postoperative day 7 in order to verify the absence of local complications. All the individual factors and those related to the procedure were analyzed. RESULTS With criteria of complications related to the gesture, 72 patients (72.7%) were considered ready to be discharged as of postoperative hour 4. Among the 27 patients who were not able to leave, 7 presented with an early local complication without reoperation, and 20 could not walk because of a necrotic lesion (n = 8), their advanced age (n = 4), morbid obesity (n = 2), or a choice of the surgeon in charge (n = 6). Twenty-five patients could, however, stroll after 12 hours. The mean duration of hospitalization was 1.3 days (range: 0-10 days). Two patients required distal amputation during the same hospitalization, and 1 underwent a femoropopliteal bypass after failure of a femoropopliteal recanalization. With univariate analysis, the treatment by anticoagulants and the duration of the hospitalization were the only factors significantly related to the impossibility of early ambulation. The occurrence of complications was linked with the experience of the surgeon, the age of the patient, and the female sex. Three patients, including 2 regarded as ready to walk by postoperative hour 4, were rehospitalized after 1 week for reoperation because of 1 major hematoma and 2 femoral false aneurysms. CONCLUSION Percutaneous endovascular surgery by the femoral route without using an arterial closure system is feasible in an ambulatory practice in nearly 75% of cases. Particular monitoring must be done in the oldest patients, women, and those treated with anticoagulants.
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Affiliation(s)
- Djelloul Gouicem
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Laura Palcau
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Claire Le Hello
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Lucie Cameliere
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Julie Dufranc
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Olivier Coffin
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Ludovic Berger
- Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Caen, Caen, France.
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Sheth RA, Walker TG, Saad WE, Dariushnia SR, Ganguli S, Hogan MJ, Hohenwalter EJ, Kalva SP, Rajan DK, Stokes LS, Zuckerman DA, Nikolic B. Quality improvement guidelines for vascular access and closure device use. J Vasc Interv Radiol 2013; 25:73-84. [PMID: 24209907 DOI: 10.1016/j.jvir.2013.08.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 08/15/2013] [Accepted: 08/16/2013] [Indexed: 12/17/2022] Open
Affiliation(s)
- Rahul A Sheth
- Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray 290, Boston, MA 02114
| | - T Gregory Walker
- Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray 290, Boston, MA 02114
| | - Wael E Saad
- Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan.
| | - Sean R Dariushnia
- Department of Interventional Radiology and Image-guided Medicine, Emory University, Atlanta, Georgia
| | - Suvranu Ganguli
- Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray 290, Boston, MA 02114
| | - Mark J Hogan
- Section of Vascular and Interventional Radiology, Department of Radiology, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Eric J Hohenwalter
- Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin
| | - Sanjeeva P Kalva
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dheeraj K Rajan
- Department of Medical Imaging, University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Leann S Stokes
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Darryl A Zuckerman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Boris Nikolic
- Department of Radiology, Stratton Medical Center, Albany, New York
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Vavuranakis M, Kariori M, Voudris V, Kalogeras K, Vrachatis D, Aznaouridis C, Moldovan C, Masoura C, Thomopoulou S, Lazaros G, Stefanadis C. Predictive Factors of Vascular Complications after Transcatheter Aortic Valve Implantation in Patients Treated with a Default Percutaneous Strategy. Cardiovasc Ther 2013; 31:e46-54. [DOI: 10.1111/1755-5922.12023] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Manolis Vavuranakis
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Maria Kariori
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Vassilis Voudris
- 2nd Department of Cardiology; Onassis Cardiac Surgery Center; Athens; Greece
| | - Konstantinos Kalogeras
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Dimitrios Vrachatis
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Constantinos Aznaouridis
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Carmen Moldovan
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Constantina Masoura
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Sophia Thomopoulou
- 2nd Department of Cardiology; Onassis Cardiac Surgery Center; Athens; Greece
| | - Georgios Lazaros
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
| | - Christodoulos Stefanadis
- 1st Department of Cardiology; Hippokration Hospital; Medical School; National & Kapodistrian University of Athens; Athens; Greece
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Kim WH, Shin S, Ko YG, Hong MK, Jang Y, Choi D. Efficacy and Safety of the Preclose Technique Following Percutaneous Aortic Stent-Graft Implantation. J Endovasc Ther 2013; 20:350-5. [DOI: 10.1583/12-4103mr2.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Use of a thrombin-gelatin matrix for hemostasis after failed device closure of femoral arterial access. Cardiovasc Intervent Radiol 2013; 37:281-3. [PMID: 23354959 DOI: 10.1007/s00270-013-0545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 12/19/2012] [Indexed: 10/27/2022]
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Funke C, Pfiffner R, Husmann M, Pfammatter T. The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia. Cardiovasc Intervent Radiol 2012; 36:377-84. [DOI: 10.1007/s00270-012-0455-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 07/15/2012] [Indexed: 12/17/2022]
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Hsu CCT, Kwan GNC, Rophael JA, Anthony C, van Driel ML. Vascular closure devices for femoral arterial puncture site haemostasis. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Influence of Use of a Vascular Closure Device on Incidence and Surgical Management of Access Site Complications after Percutaneous Interventions. Eur J Vasc Endovasc Surg 2011; 42:230-5. [DOI: 10.1016/j.ejvs.2011.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 03/14/2011] [Indexed: 11/18/2022]
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