Single-center experience with vascular closure devices in real-world endovascular peripheral interventions

• Published in: Journal of cardiovascular surgery Vol. 59; no. 6; p. 797
• Main Authors: Freitas, Bruno, Steiner, Sabine, Bausback, Yvonne, Staab, Holger, Branzan, Daniela, Banning-Eichenseer, Ursula, Schmidt, Andrej, Scheinert, Dierk
• Format: Journal Article
• Language: English
• Published: Italy 01.12.2018
• Subjects: Aged; Aged, 80 and over; Angiography; Blood Loss, Surgical - prevention & control; Endovascular Procedures - adverse effects; Equipment Design; Female; Germany; Hemostatic Techniques - adverse effects; Hemostatic Techniques - instrumentation; Humans; Male; Middle Aged; Peripheral Vascular Diseases - diagnostic imaging; Peripheral Vascular Diseases - surgery; Postoperative Hemorrhage - diagnostic imaging; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - prevention & control; Punctures; Retrospective Studies; Risk Factors; Ultrasonography, Doppler, Duplex; Vascular Closure Devices
• ISSN: 1827-191X
• DOI: 10.23736/S0021-9509.16.09207-7

The aim of the current study was to evaluate the efficacy and safety of vascular closure devices (VCDs) in non-cardiac endovascular interventions. Retrospective analysis of consecutive patients submitted to endovascular interventions, with deployment of 2327 vascular closure devices. Demographic, clinical/periprocedural, post-operative, complication and reintervention data were reviewed. A total of 2107 patients (1409 [66.9%] men) were included. Perclose ProGlide® (Abbott Vascular) was employed 1683 times (72.3%), Angio-Seal™ (St. Jude Medical Inc.) 463 (19.9%) and 181 (7.8%) Exoseal® (Cordis). Patients were 70.4±11 years old. Of all vascular approaches, 1794 were retrograde (77.1%) and 533 antegrade (22.9%), with sheath size ranging from 5 to 8 French. Overall success rate was 95.2% and did not significantly vary according to the device. Overall failure rate was 4.8%, with high puncture site, morbid obesity, previous total anticoagulation and severe calcification being related to worse efficiency results. Major complications occurred in 15 patients (0.6%). All patients were evaluated before discharge from the hospital, and were scheduled to return for ambulatory follow-up visits at 30 days postoperatively. Control duplex ultrasonography was performed on a regular basis, or within this period in case of clinical complain/signs. Vascular closure devices proved to be safe and effective in this study. Additional prospective randomized studies are recommended.