scholarly journals INCIDENCE OF VASCULAR COMPLICATIONS BETWEEN IN-PATIENTS UNDERGOING CARDIAC CATHETERIZATION BY FEMORAL ACCESS: MANUAL COMPRESSION VS VASCULAR CLOSURE DEVICES, A PROSPECTIVE SINGLE-CENTRE REGISTRY

2015 ◽  
Vol 31 (10) ◽  
pp. S59
Author(s):  
N. Pinilla-Echeverri ◽  
A. Jurado-Roman ◽  
I. Sanchez-Perez ◽  
F. Lozano-Ruiz Poveda ◽  
M.T. Lopez-Lluva ◽  
...  
2010 ◽  
Vol 5 (1) ◽  
pp. 93
Author(s):  
Benjamin H Holland ◽  
Robert J Applegate ◽  
◽  

Vascular closure devices (VCDs) reduce the time to haemostasis and ambulation and improve patient comfort compared with manual compression in patients undergoing vascular procedures from a femoral artery access site. Recent large, single-centre studies andpost hocdata from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial strongly suggest that newer generations of VCD decrease rates of vascular complications compared with manual compression, in contrast to earlier evaluations of first-generation devices. Unfortunately, utilisation of VCDs remains limited and mitigates the potential benefit that could result from expanded use of these devices. Newer entrants into the VCD market such as Starclose and Mynx are based on extravascular closure methodology. These devices address concerns of intravascular components of a VCD; however, whether these devices reduce vascular complications and bleeding has not been evaluated. In this brief article, we will examine these factors in greater detail and suggest an algorithm for VCD use in clinical practice.


VASA ◽  
2018 ◽  
Vol 47 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Artur I. Milnerowicz ◽  
Aleksandra A. Milnerowicz ◽  
Marcin Protasiewicz ◽  
Wiktor Kuliczkowski

Abstract. Background: Effectiveness of vascular closure devices during endovascular procedures requiring a direct puncture of a vascular prosthesis placed in the inguinal region is unknown. Patients and methods: The retrospective analysis included 134 patients with a history of polyethylene terephthalate (PETE) graft implantation in the inguinal region. In 20 (15 %) patients, haemostasis was achieved with manual compression, in 21 (16 %) with the StarClose™, and in 93 (69 %) with the AngioSeal™ device. Results: The incidence of vascular complications in the manual compression group was higher (at a threshold of statistical significance) than in the device closure group (45.0 vs. 24.5 %, p = 0.059). The difference was considered statistically significant when manual compression was compared with the AngioSeal™ closure group (45.0 vs. 13.9 %, p < 0.01). The vascular complication rate in the StarClose™ group was significantly higher than in the AngioSeal™ group (71.4 vs. 13.9 %, p < 0.000001). While haematomas were the only vascular complications observed after application of AngioSeal™, both haematomas and pseudoaneurysms were found in the StarClose™ group. Conclusions: The AngioSeal™ vascular closure device provides better local haemostasis than the StarClose™ device or manual compression during endovascular interventions requiring a direct puncture of PETE grafts


1998 ◽  
Vol 7 (4) ◽  
pp. 308-313 ◽  
Author(s):  
A Simon ◽  
B Bumgarner ◽  
K Clark ◽  
S Israel

BACKGROUND: Most cardiac catheterizations are performed via femoral artery access. Reported rates of both peripheral vascular complications and success rates for the use of manual and mechanical compression techniques to achieve femoral artery hemostasis after cardiac catheterization vary. OBJECTIVE: To determine is use of a mechanical clamp is as effective as standard manual pressure for femoral artery hemostasis after cardiac catheterization. METHODS: Subjects consisted of 720 patients from 2 community hospitals who had elective diagnostic cardiac catheterization via the femoral artery. The control group (n=343) received manual compression for hemostasis; the study group (n=377) received mechanical compression. Standard protocols were used for the 2 compression techniques. Pressure was applied for a minimum of 10 minutes for 5F and 6F sheaths and catheters and for a minimum of 15 minutes for 7F and 8F sheaths and catheters. Prospective data were collected and analyzed for each patients, including sheath or catheter size, blood pressure, height, weight, age, time from administration of local anesthetic to successful cannulation of the femoral artery, anticoagulation status, total compression time, physician performing the catheterization procedure, nurse or technician who obtained hemostasis, and complications. In follow-up, patients were asked site-specific and functional status questions 1 to 2 days after the catheterization procedure and again 3 days after the catheterization procedure. RESULTS: Data were analyzed by using frequency distributions, measures of central tendency, and measures of variability. Only 1 difference between the 2 groups was significant: manual compression time was 14.93 +/- minutes, whereas mechanical compression time was 17.13 +/- minutes. CONCLUSION: Mechanical compression is as effective as manual compression for femoral artery hemostasis after cardiac catheterization.


2011 ◽  
Vol 100 (9) ◽  
pp. 789-795 ◽  
Author(s):  
Emilia Stegemann ◽  
Rainer Hoffmann ◽  
Steven Marso ◽  
Berthold Stegemann ◽  
Nikolaus Marx ◽  
...  

2015 ◽  
Vol 21 (3) ◽  
pp. 412-417 ◽  
Author(s):  
Ramesh Grandhi ◽  
Nathan T Zwagerman ◽  
Xiaoran Zhang ◽  
Stephanie H Chen ◽  
Ashutosh P Jadhav ◽  
...  

Introduction Conventional cerebral angiography is a commonly performed procedure in medicine. Vascular closure devices have been developed as alternatives to manual compression at the arteriotomy site and prolonged bed rest. The risks of using these devices include arterial dissection, groin hematoma, and device failure. Herein, we describe our experience with the use of a novel device used for arterial access and closure, the AXERA 2 Access System. Methods A total of 13 patients underwent vascular access and closure with the AXERA 2 Access System. Results Arterial access using the AXERA 2 Access System was achieved in 11 of 13 patients. Amongst the patients with successful access, one patient experienced a groin hematoma requiring manual compression and two patients suffered occlusions of the common femoral artery due to dissections, with both patients requiring femoral artery thromboendarterectomies. Conclusions This small series highlights a heretofore underreported serious complication rate of the AXERA 2 Access System. Additional studies are warranted to provide further insight into risk factors for device failure and complication development.


2020 ◽  
Author(s):  
Armando Del Prete ◽  
Domenico Giovanni Della Rocca ◽  
Simone Calcagno ◽  
Riccardo Di Pietro ◽  
Giuseppe Del Prete ◽  
...  

In the past 20 years, numerous percutaneous vascular closure devices have been tested and compared with manual compression and to surgical cut-down. The suture-mediated closure device Perclose ProGlide™ system (Abbott Vascular, CA, USA) emerged as a safe and effective alternative for many procedures requiring either small or large bore vascular accesses. In this review, we will discuss the characteristics of this vascular closure device and the main studies that proved its potential to reduce vascular complications, time to deambulation, time to discharge and patient discomfort.


2018 ◽  
Vol 12 (3) ◽  
pp. 73-81
Author(s):  
Xi Cao ◽  
Sui Ying Fung ◽  
Yuen Yi Lai ◽  
Sek Ying Chair ◽  
Han Shi Jocelyn Chew

BackgroundTransfemoral and transradial are two common approaches for performing cardiac catheterization, while there is no consensus on which one is superior to the other.AimThis paper aimed to compare the effect of transfemoral and transradial approaches on patient's outcomes in terms of back pain, vascular complications, and urinary discomfort in those undergoing diagnostic cardiac catheterization.MethodsA secondary data analysis method was used.ResultsThe results showed that transradial access could significantly reduce back pain compared to femoral access. While no significant difference was found for vascular complications and urinary discomfort between the two methods.ConclusionThe findings of this study indicate that transradial approach could reduce patients' back pain without increasing the incidence of vascular complications. Additionally, with early mobility, nursing care time could be reduced. Thus, it can be used as an alternative approach for the transfemoral approach.


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