scholarly journals Successful Use of the MYNXGRIP Closure Device during Repeated Transbrachial Percutaneous Peripheral Intervention

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Klaus Hertting ◽  
Werner Raut
Keyword(s):  
Arterial Intervention ◽  
Arterial Puncture ◽  
Closure Device ◽  
Peripheral Arterial

The use of closure devices after transbrachial arterial puncture is still controversial. Here we report on a case where the MYNXGRIP (AccessClosure Inc., Santa Clara, CA, USA) could be used successfully in a patient, who underwent percutaneous peripheral arterial intervention twice via transbrachial access.

Incidence of venous thrombosis following peripheral arterial interventions. A prospective study

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 359-363
Author(s):  
Schwarz ◽  
Rastan ◽  
Sixt ◽  
Schwarzwälder ◽  
Neumann ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Arterial Intervention ◽  
Closure Device ◽  
Compression Bandage ◽  
Vein Thrombosis ◽  
Compression Bandages ◽  
Compression Ultrasound ◽  
Peripheral Arterial ◽  
Deep Vein

Background: The objective of the study was to investigate the incidence of deep vein thrombosis (DVT) at the puncture site following peripheral interventions and to assess if there is a difference between using a vascular closure by means of vascular closure systems or compression bandages. Patients and methods: We prospectively included 474 consecutive patients after peripheral arterial interventions. The day after peripheral arterial intervention we performed venous compression ultrasound to exclude DVT in the area of the groin. We recorded management of arterial closure and subsequent antithrombotic treatment of the patient. Four weeks after intervention follow-up was performed by phone to exclude clinical DVT, pulmonary embolism (PE), and death. Results: We included 474 consecutive patients (mean age 69 y; 298 male / 176 female). All patients were under oral antiplatelet therapy. Vascular closure was achieved in 296 patients (62.44%) by Femostop™ followed by compression bandage and in 178 (37.56 %) by using a vascular closure device alone. Sonography revealed no DVT the day after intervention, no clinical PE occurred. Four weeks follow-up showed no DVT, but there was one patient in the compression bandage group who had PE without proven deep vein thrombosis. Two patients died from other reasons than PE. Conclusions: The immediate and mid-term risk of DVT after peripheral arterial interventions is extremely low and is not increased if compression bandages are used for vascular closure.

scholarly journals P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
MI Qureshi ◽  
HL Li ◽  
GK Ambler ◽  
KHF Wong ◽  
S Dawson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Arterial Disease ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Endovascular Intervention ◽  
Randomised Trials ◽  
Peripheral Arterial ◽  
High Level

Abstract Introduction Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention. Method This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention. Result Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified. Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies. Conclusion Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies. Take-home message To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

Clinical and economic burden of heparin-induced thrombocytopenia in hospitalized patients undergoing percutaneous peripheral arterial interventions

Vascular ◽  
2019 ◽  
Vol 28 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Ahmed Subahi ◽  
Mohammed Osman ◽  
Oluwole Adegbala ◽  
Hossam Abubakar ◽  
Babikir Kheiri ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Pulmonary Embolism ◽  
Ischemic Stroke ◽  
Venous Thrombosis ◽  
Arterial Intervention ◽  
Kidney Injury ◽  
Heparin Induced Thrombocytopenia ◽  
Baseline Characteristics ◽  
Peripheral Arterial ◽  
Prolonged Hospital

Background Percutaneous peripheral arterial intervention (PPAI) patients are at a high risk of developing heparin-induced thrombocytopenia due to the need for repeated and prolonged heparin exposure. We sought to investigate the incidence, outcomes, and economic impact of heparin-induced thrombocytopenia post-PPAI utilizing the National Inpatient Sample. Methods All patients who underwent PPAI (age ≥18 years) from 2007 to 2014 were identified by using ICD-9-CM codes. Patients were then classified into two groups based on the presence or absence of heparin-induced thrombocytopenia during hospitalization. In-hospital outcomes were compared between the two groups after propensity-score matching to account for differences in baseline characteristics. Results Heparin-induced thrombocytopenia was reported in 527 patients (0.23%). After adjusting for patient-level and hospital-level characteristics, in-hospital mortality differences were not significantly different between patients with heparin-induced thrombocytopenia vs. those without heparin-induced thrombocytopenia (odds ratio (OR) 1.02, 95% confidence interval (CI) 0.67 to 1.57, p = 0.951). However, PPAI patients with heparin-induced thrombocytopenia were more likely to develop ischemic stroke (OR 3.84, 95%CI 1.26 to 11.75, p = 0.018), deep venous thrombosis/pulmonary embolism (OR 1.32, 95%CI 0.79 to 1.79, p = 0.078), and acute kidney injury requiring dialysis (OR 4.04, 95%CI 1.72 to 9.50, p = 0.001). Furthermore, post-PPAI patients who developed heparin-induced thrombocytopenia had longer hospitalizations (13.8 vs. 9.8 days, p < 0.0001), higher cost of stay ($62,022 vs. $44,904, p < 0.0001), and higher rates of non-routine home discharges (50.15% vs. 42.19%, p = 0.013). Conclusion Among patients who underwent PPAI, heparin-induced thrombocytopenia was associated with a higher risk of venous thrombosis/pulmonary embolism, ischemic stroke, acute kidney injury requiring dialysis, prolonged hospital stay, and increased cost.

Arterial closure device to achieve hemostasis in children following percutaneous femoral arterial puncture

2013 ◽  
Vol 43 (6) ◽  
pp. 703-708 ◽  
Author(s):  
Somnath J. Prabhu ◽  
Siddharth A. Padia ◽  
Karim Valji ◽  
Michael F. McNeeley ◽  
Sandeep Vaidya ◽  
...  
Keyword(s):  
Arterial Puncture ◽  
Closure Device ◽  
Arterial Closure Device

scholarly journals Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256317
Author(s):  
Hunor Sarkadi ◽  
Judit Csőre ◽  
Dániel Sándor Veres ◽  
Nándor Szegedi ◽  
Levente Molnár ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ulnar Artery ◽  
High Volume ◽  
Arterial Puncture ◽  
Control Group ◽  
Closure Device ◽  
Ultrasound Guided ◽  
Laboratory Findings ◽  
Pseudoaneurysm Formation ◽  
Rbc Count

Purpose To evaluate factors associated with pseudoaneurysm (PSA) development. Methods Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA were identified. A matched (age, gender, and type of the procedure) control group of 134 patients was created to reveal predictors of PSA formation. Results Single PSAs were found in 134 patients. Fifty-three PSAs developed after radiological procedures (53/6555 [0.8%]), 31 after coronary artery procedures (31/18038 [0.2%]), 25 after non-coronary artery cardiac procedures (25/5603 [0.4%]), and 25 due to procedures in which the arterial puncture was unintended. Thirty-four PSAs (25.4%) were localized to the upper extremity arteries (vascular closure device [VCD], N = 0), while 100 (74.6%) arose from the lower extremity arteries (VCD, N = 37). The PSA prevalence was 0.05% (10/20478) in the radial artery, 0.1% (2/1818) in the ulnar artery, 1.2% (22/1897) in the brachial artery, and 0.4% (99/22202) in the femoral artery. Treatments for upper and lower limb PSAs were as follows: bandage replacement (32.4% and 14%, respectively), ultrasound-guided compression (11.8% and 1%, respectively), ultrasound-guided thrombin injection (38.2% and 78%, respectively), and open surgery (17.6% and 12%, respectively). Reintervention was necessary in 19 patients (14.2%). The prevalence of PSA for the punctured artery with and without VCD use was 37/3555 (1%) and 97/27204 (0.4%), respectively (OR, 2.94; 95% CI, 1.95–4.34; P<0.001). The effect of red blood cell (RBC) count (P<0.001), hematocrit value (P<0.001), hemoglobin value (P<0.001), international normalized ratio (INR; P<0.001), RBC count—INR interaction (P = 0.003), and RBC count—VCD use interaction (P = 0.036) on PSA formation was significant. Conclusion Patients in whom the puncture site is closed with a VCD require increased observation. Preprocedural laboratory findings are useful for the identification of patients at high risk of PSA formation.

Infrainguinal Arterial Intervention: Is There a Role for an Atherectomy Device?

Vascular ◽  
2006 ◽  
Vol 14 (5) ◽  
pp. 313-318 ◽  
Author(s):  
Leila Mureebe ◽  
James F. McKinsey
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Atheromatous Plaque ◽  
Peripheral Arteries ◽  
Invasive Treatment ◽  
Attractive Option ◽  
Percutaneous Removal ◽  
Peripheral Arterial ◽  
Redwood City

Excision of atheromatous plaque is an attractive option for the minimally invasive treatment of peripheral arterial disease. Approved for use in 2003, the SilverHawk Plaque Exicison System (FoxHollow Technologies, Redwood City, CA) is a catheter-based plaque excision device allowing percutaneous removal of atheromatous material. This device represents the most recent generation of atherectomy tools. Overall experience with plaque debulking in the peripheral arteries spans almost two decades, and understanding of the technique continues to evolve. This article reviews the technology, current practices, and data on plaque excision.

Angio-Seal Use in Patients with Peripheral Arterial Disease (ASPIRE)

Angiology ◽  
2009 ◽  
Vol 60 (5) ◽  
pp. 536-538 ◽  
Author(s):  
Reinhold Katzenschlager ◽  
Reinhold Tischler ◽  
Georg Kalchhauser ◽  
Michael Panny ◽  
Mirko Hirschl
Keyword(s):  
Peripheral Arterial Disease ◽  
Risk Groups ◽  
Arterial Disease ◽  
Closure Device ◽  
Puncture Site ◽  
Complication Risk ◽  
Device Deployment ◽  
Velocity Changes ◽  
Peripheral Arterial ◽  
Arterial Closure Device

Purpose To investigate the incidence of complications after the use of an arterial closure device (Angio-Seal) in patients with peripheral arterial disease. Methods In 105 consecutive patients after transfemoral catheterization, the puncture site was closed using a closure device (Angio-Seal). Colourflow-duplexsonography studies were conducted 1 to 4 days before, within 3 days after and 3 month after the intervention. Results All patients had peripheral arterial disease, 34 had calcification at the puncture site. Detection of calcification did not prevent device deployment. Complications (2 minor bleedings, 1 pseudoaneurysm) were not associated with high risk groups (these were: 69 antegrade punctures, 22 obese and 32 hypertensive patients). Three-month postinterventional diameter and blood velocity changes were <1%. Conclusions Patients with peripheral arterial disease in the region of the puncture site and patients at higher complication risk can safely and effectively be closed with an Angio-Seal device. At the puncture site, no lumen change can be observed 3 months postinterventional.

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