REGULAR CONTENT
Final ID
595
Type
Educational Exhibit-Poster Only
Authors
D Gans1, C Sutter1, J Davidson1, S Tavri1, E McLoney1, I Patel1
Institutions
1University Hospitals - Cleveland Medical Center, Cleveland, OH
Purpose
-Review manual compression technique as the gold standard-Discuss complications of femoral arteriotomy, leading to development of vascular closure devices (VCD)-Analyze currently available active closure device VCDs and their mechanisms of action, techniques, patient selection, technical success rates, complication rates, and learning curves-Review the SIR 'Quality Improvement Guidelines for Vascular Access and Closure Device Use' (1)-Update on most recently developed VCDs: efficacy, indications, complications
Materials & Methods
Although manual compression is the 'gold standard' for achieving hemostasis following femoral arteriotomy, its use is limited due to patient discomfort, required bedrest, and obesity. Therefore, vascular closure devices (VCD) were developed in the early 1990s as means to earlier ambulation, improved patient comfort, and potentially less complications (2). VCDs are categorized as active closure devices, compression assist devices, or topical hemostasis devices. Active closure devices either physically close the arteriotomy with sutures, clips or staples, or seal the arteriotomy site, with plugs, sealants, or gels. Compression assist devices provide external pressure directly on the arteriotomy site. Topical hemostasis devices are pads with procoagulant to accelerate hemostasis. We aim to provide an overview as well as review the current literature regarding active closure devices Angio-seal, FISH, Mynx, Exoseal, Perclose, and Starclose. Additionally, newer devices, specifically for large-bore arteriotomy closure will be discussed.
Results
Since the publication of the SIR 'Quality Improvement Guidelines for Vascular Access and Closure Device Use' (1), a new large meta-analysis(3) and a Cochrane Review(4) evaluating VCDs have been published, demonstrating their safety and efficacy. Some newer literature demonstrates decreased risk of hematoma with VCD compared to manual compression.
Conclusions
There are many different types of VCDs, each with advantages, disadvantages, and individual risks. Newer devices are on the horizon with focus on large-bore arteriotomy closure. Manual compression remains the 'gold standard'.
Final ID
595
Type
Educational Exhibit-Poster Only
Authors
D Gans1, C Sutter1, J Davidson1, S Tavri1, E McLoney1, I Patel1
Institutions
1University Hospitals - Cleveland Medical Center, Cleveland, OH
Purpose
-Review manual compression technique as the gold standard-Discuss complications of femoral arteriotomy, leading to development of vascular closure devices (VCD)-Analyze currently available active closure device VCDs and their mechanisms of action, techniques, patient selection, technical success rates, complication rates, and learning curves-Review the SIR 'Quality Improvement Guidelines for Vascular Access and Closure Device Use' (1)-Update on most recently developed VCDs: efficacy, indications, complications
Materials & Methods
Although manual compression is the 'gold standard' for achieving hemostasis following femoral arteriotomy, its use is limited due to patient discomfort, required bedrest, and obesity. Therefore, vascular closure devices (VCD) were developed in the early 1990s as means to earlier ambulation, improved patient comfort, and potentially less complications (2). VCDs are categorized as active closure devices, compression assist devices, or topical hemostasis devices. Active closure devices either physically close the arteriotomy with sutures, clips or staples, or seal the arteriotomy site, with plugs, sealants, or gels. Compression assist devices provide external pressure directly on the arteriotomy site. Topical hemostasis devices are pads with procoagulant to accelerate hemostasis. We aim to provide an overview as well as review the current literature regarding active closure devices Angio-seal, FISH, Mynx, Exoseal, Perclose, and Starclose. Additionally, newer devices, specifically for large-bore arteriotomy closure will be discussed.
Results
Since the publication of the SIR 'Quality Improvement Guidelines for Vascular Access and Closure Device Use' (1), a new large meta-analysis(3) and a Cochrane Review(4) evaluating VCDs have been published, demonstrating their safety and efficacy. Some newer literature demonstrates decreased risk of hematoma with VCD compared to manual compression.
Conclusions
There are many different types of VCDs, each with advantages, disadvantages, and individual risks. Newer devices are on the horizon with focus on large-bore arteriotomy closure. Manual compression remains the 'gold standard'.