scholarly journals Clinical and Subclinical Femoral Vascular Complications after Deployment of two Different Vascular Closure Devices or Manual Compression in the Setting of Coronary Intervention

2016 ◽  
Vol 13 (4) ◽  
pp. 255-259 ◽  
Author(s):  
Hakan Yeni ◽  
Meissner Axel ◽  
Ahmet Örnek ◽  
Thomas Butz ◽  
Petra Maagh ◽  
...  
Keyword(s):  
Vascular Complications ◽  
Coronary Intervention ◽  
Manual Compression ◽  
Vascular Closure Devices

Use of vascular closure devices for endovascular interventions requiring a direct puncture of PETE grafts

VASA ◽  
2018 ◽  
Vol 47 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Artur I. Milnerowicz ◽  
Aleksandra A. Milnerowicz ◽  
Marcin Protasiewicz ◽  
Wiktor Kuliczkowski
Keyword(s):  
Statistical Significance ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Inguinal Region ◽  
Closure Device ◽  
Manual Compression ◽  
Direct Puncture ◽  
Endovascular Interventions ◽  
Vascular Closure Devices ◽  
Closure Group

Abstract. Background: Effectiveness of vascular closure devices during endovascular procedures requiring a direct puncture of a vascular prosthesis placed in the inguinal region is unknown. Patients and methods: The retrospective analysis included 134 patients with a history of polyethylene terephthalate (PETE) graft implantation in the inguinal region. In 20 (15 %) patients, haemostasis was achieved with manual compression, in 21 (16 %) with the StarClose™, and in 93 (69 %) with the AngioSeal™ device. Results: The incidence of vascular complications in the manual compression group was higher (at a threshold of statistical significance) than in the device closure group (45.0 vs. 24.5 %, p = 0.059). The difference was considered statistically significant when manual compression was compared with the AngioSeal™ closure group (45.0 vs. 13.9 %, p < 0.01). The vascular complication rate in the StarClose™ group was significantly higher than in the AngioSeal™ group (71.4 vs. 13.9 %, p < 0.000001). While haematomas were the only vascular complications observed after application of AngioSeal™, both haematomas and pseudoaneurysms were found in the StarClose™ group. Conclusions: The AngioSeal™ vascular closure device provides better local haemostasis than the StarClose™ device or manual compression during endovascular interventions requiring a direct puncture of PETE grafts

Femoral Closure – Devices and Strategies in 2010

2010 ◽  
Vol 5 (1) ◽  
pp. 93
Author(s):  
Benjamin H Holland ◽  
Robert J Applegate ◽  
◽  
Keyword(s):  
First Generation ◽  
Vascular Complications ◽  
Patient Comfort ◽  
Manual Compression ◽  
Single Centre ◽  
Access Site ◽  
Vascular Closure Devices ◽  
Improve Patient Comfort ◽  
Post Hoc ◽  
Improve Patient

Vascular closure devices (VCDs) reduce the time to haemostasis and ambulation and improve patient comfort compared with manual compression in patients undergoing vascular procedures from a femoral artery access site. Recent large, single-centre studies andpost hocdata from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial strongly suggest that newer generations of VCD decrease rates of vascular complications compared with manual compression, in contrast to earlier evaluations of first-generation devices. Unfortunately, utilisation of VCDs remains limited and mitigates the potential benefit that could result from expanded use of these devices. Newer entrants into the VCD market such as Starclose and Mynx are based on extravascular closure methodology. These devices address concerns of intravascular components of a VCD; however, whether these devices reduce vascular complications and bleeding has not been evaluated. In this brief article, we will examine these factors in greater detail and suggest an algorithm for VCD use in clinical practice.

Management of Haemostasis with Combined Use of Vascular Closure Devices and Bivalirudin – A Review

2011 ◽  
Vol 6 (2) ◽  
pp. 177
Author(s):  
Emanuela de Cillis ◽  
Giuseppe Massimo Sangiorgi ◽  
Alessandro Santo Bortone ◽  
◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Closure Device ◽  
Vascular Closure Device ◽  
High Risk Patients ◽  
Vascular Closure Devices ◽  
Combined Use ◽  
Percutaneous Coronary ◽  
Risk Patients

Bleeding and vascular complications related to invasive cardiovascular procedures are associated with significant morbidity and mortality. The aim of this article is to evaluate the literature to determine haemostasis strategies in percutaneous coronary intervention when using bivalirudin with or without a vascular closure device. The literature data seem to underline that the combination of vascular closure devices and bivalirudin was associated with significantly lower bleeding rates. However, these strategies were less often used among high-risk patients. We recommend that prospective clinical studies are undertaken to determine the potential disadvantages of using vascular closure devices and bivalirudin in combination in high-risk patients.

Perclose Proglide™ for vascular closure

2020 ◽  
Author(s):  
Armando Del Prete ◽  
Domenico Giovanni Della Rocca ◽  
Simone Calcagno ◽  
Riccardo Di Pietro ◽  
Giuseppe Del Prete ◽  
...  
Keyword(s):  
Vascular Complications ◽  
Effective Alternative ◽  
Closure Device ◽  
Manual Compression ◽  
Vascular Closure Device ◽  
Patient Discomfort ◽  
The Past ◽  
Vascular Closure Devices

In the past 20 years, numerous percutaneous vascular closure devices have been tested and compared with manual compression and to surgical cut-down. The suture-mediated closure device Perclose ProGlide™ system (Abbott Vascular, CA, USA) emerged as a safe and effective alternative for many procedures requiring either small or large bore vascular accesses. In this review, we will discuss the characteristics of this vascular closure device and the main studies that proved its potential to reduce vascular complications, time to deambulation, time to discharge and patient discomfort.

scholarly journals Vascular Complications from Coronary Angiography/Percutaneous Coronary Intervention: Comparing Day Case Patients and Inpatients in a Tertiary Hospital in Thailand: A Retrospective Cohort Stud

2020 ◽  
Author(s):  
Chantana Charoensin ◽  
Ratchanee Srichai ◽  
Thammasin Ingviya
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Retrospective Cohort ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Closure Device ◽  
Day Case ◽  
Vascular Closure Devices ◽  
Percutaneous Coronary

Objective: To compare the incidence along with risk factors of vascular complications between patients having undergone Coronary angiography/Percutaneous Coronary Interventions (CAG/PCIs); as day cases and those as inpatients. Material and Methods: Our study is a retrospective cohort study. We performed a retrospective chart review of the patients, visiting a heart center of the hospital from October, 2014 to September, 2018. We included patients of a minimum 18 years of age, who had undergone CAG/PCIs. Excluded patients were those who had been referred from other hospitals. The main outcomes were vascular complications defined as: (1) bleeding with significant blood loss during the procedure. (2) Hematoma within 1 month after the procedure. Wilcoxon’s rank sum and chi-squared test were used to assess the risk factors. Results: Of all 784 patients having undergone CAG/PCI, 387 were day cases and 397 were inpatients. Only 12 cases developed vascular complications. The incidence of vascular complications was not significantly different between either day case; whose incidence was 1.3% (95% confidence interval (CI), 0.72-1.87), and inpatients; whose incidence was 1.8% (95% CI, 1.10-2.42). We found that the risk factors of vascular complications were percutaneous coronary intervention, and using a vascular closure device to remove the introducer sheath. Conclusion: Performing CAG/PCI as day cases did not increase the risks of complications post-procedure, as compare to the inpatients. However, due to the small numbers of patients with complications future studies with more patients are needed to ensure the safety of day case CAG/PCI. Patients undergoing PCI, or patients with vascular closure devices used should be closely observed before discharge.

Downsizing – the Future of Interventional Cardiology

2012 ◽  
Vol 7 (1) ◽  
pp. 28
Author(s):  
Giovanni Amoroso ◽  
Keyword(s):  
Contrast Agent ◽  
Vascular Complications ◽  
Cost Savings ◽  
Length Of Hospital Stay ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Transradial Approach ◽  
Technical Developments ◽  
Coronary Procedures ◽  
Angiographic Image

The concept of downsized catheters (i.e., using catheters smaller than 6 French) for invasive coronary procedures, such as diagnostic cardiac catheterisation and percutaneous coronary intervention, has been developing over the years, particularly as a result of the rise of the transradial approach. Recent advances have allowed the use of smaller and sheathless catheters, which confer a number of advantages – such as fewer vascular complications, reduced use of contrast agent and reduced haemostasis – thus increasing patient safety and comfort and allowing more rapid patient mobilisation. Reductions in patient complications, number and length of hospital stay, and amount of contrast agent used can also lead to cost savings. While the use of smaller catheters has been hindered in the past because of poor angiographic image quality, new automated contrast injectors have helped overcome this limitation. There is a need to make interventional cardiologists worldwide more aware of the benefits of downsizing, in the light of the latest technical developments and the increased use of transradial approach.

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