Obtaining Hemostasis at Puncture Sites

2018 ◽  
Author(s):  
Sreekumar Madassery
Keyword(s):  
Femoral Artery ◽  
Gold Standard ◽  
Closure Device ◽  
Manual Compression ◽  
Vascular Closure Device ◽  
Vessel Size ◽  
Arterial Access

This chapter pertains to femoral artery access. Attaining an “ideal” access is essential for maximizing the chances of maintaining effective hemostasis. Deciding whether to perform arterial access closure using the gold standard of manual compression versus a vascular closure device (VCD) requires the operator to evaluate many characteristics of the patient. The location of the arteriotomy, vessel size, degree of calcification, use of anticoagulants, and sheath size during the procedure are the primary factors that need to be considered. The ISAR-CLOSURE study reported that use of VCDs was not inferior to manual compression. This chapter discusses applications and potential complications of VCDs.

A New Access Site Management Tool: The Angio-Seal™ Hemostatic Puncture Closure Device

1995 ◽  
Vol 2 (3) ◽  
pp. 289-296 ◽  
Author(s):  
Michel Henry ◽  
Max Amor ◽  
Mohamed Allaoui ◽  
Olivier Tricoche
Keyword(s):  
Arterial Wall ◽  
Bypass Graft ◽  
Vascular Complications ◽  
Common Femoral Artery ◽  
Management Tool ◽  
Closure Device ◽  
Manual Compression ◽  
Vascular Closure Device ◽  
Arterial Lumen ◽  
Manual Pressure

Purpose: Given the increasing number of percutaneously applied endovascular therapies, the incidence of access-related vascular complications can be expected to rise, particularly in association with those techniques requiring large sheaths or anticoagulation. The need exists for a safe, easy to use, and effective hemostatic technique to replace the labor-intensive method of manual compression. Methods: A bioabsorbable, sheath-delivered vascular closure device (Angio-Seal™) has been developed that deposits a small collagen plug within the arterial wall to mechanically seal the puncture defect. An anchor connected by suture to the plug is first deployed in the arterial lumen and pulled flush against the interior arterial wall to guard against intraluminal deposition of the collagen. Results: The Angio-Seal device was deployed successfully in 80 (96%) of 83 attempts involving common femoral arteries accessed for peripheral angioplasty (n = 30), coronary angiography (n = 30), and coronary angioplasty (n = 16). Three popliteal artery access sites and one femoropopliteal bypass graft were also treated. Hemostasis was immediate in 78 cases (98%); 2 sites required a 5-minute manual compression to effect a secure seal. Three devices failed to deploy, and manual pressure was used to close the puncture. Nondeployment did not cause any sequelae, and no complications were encountered with the technique. Conclusions: This novel vascular closure device is quick (< 1 minute application time) and simple to use, providing a positive seal of common femoral artery puncture sites for both peripheral and coronary interventions. It appears to be a reliable alternative to standard manual hemostasis.

Percutaneous nitinol‐based vascular closure device for large bore arterial access hemostasis: Results of a prospective multicenter study

2020 ◽  
Vol 96 (2) ◽  
pp. 473-478 ◽  
Author(s):  
Israel M. Barbash ◽  
Ran Kornowski ◽  
Anat Berkovitch ◽  
Abid Assali ◽  
Magdalena Erlebach ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Closure Device ◽  
Vascular Closure Device ◽  
Prospective Multicenter Study ◽  
Arterial Access

Evaluation of the 6-F ExoSeal Vascular Closure Device in Antegrade Femoral Artery Punctures

2012 ◽  
Vol 19 (6) ◽  
pp. 836-843 ◽  
Author(s):  
Daniel Maxien ◽  
Barbara Behrends ◽  
Karla M. Eberhardt ◽  
Tobias Saam ◽  
Sven F. Thieme ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Closure Device ◽  
Vascular Closure Device

The MANTA Vascular Closure Device for Percutaneous Femoral Vessel Cannulation in Minimally Invasive Surgical Mitral Valve Repair

2020 ◽  
Vol 15 (6) ◽  
pp. 568-571
Author(s):  
Karel M. Van Praet ◽  
Markus Kofler ◽  
Stephan Jacobs ◽  
Volkmar Falk ◽  
Axel Unbehaun ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Closure Device ◽  
Valve Repair ◽  
Vascular Closure Device ◽  
Arterial Access ◽  
Minimally Invasive Surgical ◽  
Posterior Mitral Leaflet ◽  
Leaflet Prolapse

A 65-year-old Caucasian male was referred to our institution with severe mitral regurgitation due to posterior mitral leaflet prolapse. The patient underwent minimally invasive surgical mitral valve repair. Here we present the application of a new vascular closure device (MANTA) for percutaneous arterial access and closure.

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