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

J Cardiovasc Surg (Torino). 2018 Dec;59(6):797-803. doi: 10.23736/S0021-9509.16.09207-7. Epub 2016 Nov 23.

Abstract

Background: The aim of the current study was to evaluate the efficacy and safety of vascular closure devices (VCDs) in non-cardiac endovascular interventions.

Methods: 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.

Results: 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.

Conclusions: Vascular closure devices proved to be safe and effective in this study. Additional prospective randomized studies are recommended.

Publication types

  • Observational Study

MeSH terms

  • 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*