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.
Access site management with vascular closure devices for percutaneous transarterial procedures
