Appropriate hemostasis by routine use of ultrasound echo-guided transfemoral access and vascular closure devices after lower extremity percutaneous revascularization

Cardiovasc Interv Ther. 2017 Jul;32(3):233-240. doi: 10.1007/s12928-016-0409-x. Epub 2016 Jul 18.

Abstract

To assess the safety and efficacy of routine use of ultrasound-guided puncture and the use of vascular closure device (VCD) in patients undergoing endovascular therapy (EVT) through femoral access. This was a single-center, non-randomized clinical study that enrolled 513 patients undergoing EVT via femoral artery access in which hemostasis was achieved using VCDs (406-patient EXOSEAL arm and 107-patient PROGLIDE arm). All cases were performed by routine use of ultrasound-guided access. The primary endpoint was the achievement of hemostasis without periprocedural and 30-day incidence of major or minor access site-related complications. The primary endpoint was achieved in 91.6 % of the cases (470/513) with a higher success rate in the EXOSEAL arm (93.6). Major complications were observed in 5 patients (0.9 %) in total cohort and 3 patients (0.7 %) treated with EXOSEAL arm vs. 2 patients (1.8 %) with PROGLIDE arm (p = 0.32). Combined treatment two VCDs with the routine ultrasound guidance access for patients who underwent the EVT procedure showed high efficacy and safety outcomes.

Keywords: Endovascular therapy; Peripheral artery disease; Ultrasound guided access; Vascular closure devices.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Female
  • Femoral Artery / surgery*
  • Hemostasis, Surgical / methods*
  • Humans
  • Male
  • Peripheral Arterial Disease / surgery
  • Ultrasonography, Interventional / methods*
  • Vascular Closure Devices* / adverse effects