The "Woggle" Technique for Venous Access Site Management: An Old Technique for a New Need

J Clin Med. 2023 Sep 20;12(18):6087. doi: 10.3390/jcm12186087.

Abstract

Background: Several closure devices are routinely used for percutaneous arterial access, while a relatively low number is available for the management of large bore venous accesses. The Woggle technique is a modification of the purse-string suture which was introduced several years ago in patients undergoing hemodialysis.

Methods: A population of 45 patients who underwent transvenous femoral structural heart interventions was retrospectively evaluated. The Woggle technique consists of a purge string suture with a collar to maintain the tension as stable over time and a suture lock to tighten the suture.

Results: Sheaths magnitude ranged from 8 French (F) to 14 F. A rapid post-procedural hemostasis was achieved in the whole population, and in 95% of cases, definite hemostasis was obtained after the first single release; the mean time of release was 302 ± 83 min. Although no relevant bleedings were reported, a significant reduction in hemoglobin levels was found in the whole population. This decrement was statistically significant only in the group with sheaths higher than 12 F. A single mild local hematoma was recorded in the group in which smaller sheaths were used. Seventy-two percent of patients were pre-treated with a dual antiplatelet therapy.

Conclusions: The Woggle technique has shown to be a simple, effective, and safe approach for the management of large bore venous in percutaneous structural heart interventions.

Keywords: large bore venous access; percutaneous closure vascular systems; percutaneous structural heart intervention.

Grants and funding

This work was supported partially by Italian Ministry of Health, Ricerca Corrente Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico.