Freitas Bruno, Steiner Sabine, Bausback Yvonne, Staab Holger, Branzan Daniela, Banning-Eichenseer Ursula, Schmidt Andrej, Scheinert Dierk
Division of Interventional Angiology, Leipzig University Hospital, Leipzig, Germany -
Division of Interventional Angiology, Leipzig University Hospital, Leipzig, Germany.
J Cardiovasc Surg (Torino). 2018 Dec;59(6):797-803. doi: 10.23736/S0021-9509.16.09207-7. Epub 2016 Nov 23.
The aim of the current study was to evaluate the efficacy and safety of vascular closure devices (VCDs) in non-cardiac endovascular interventions.
Retrospective analysis of consecutive patients submitted to endovascular interventions, with deployment of 2327 vascular closure devices. Demographic, clinical/periprocedural, post-operative, complication and reintervention data were reviewed.
A total of 2107 patients (1409 [66.9%] men) were included. Perclose ProGlide® (Abbott Vascular) was employed 1683 times (72.3%), Angio-Seal™ (St. Jude Medical Inc.) 463 (19.9%) and 181 (7.8%) Exoseal® (Cordis). Patients were 70.4±11 years old. Of all vascular approaches, 1794 were retrograde (77.1%) and 533 antegrade (22.9%), with sheath size ranging from 5 to 8 French. Overall success rate was 95.2% and did not significantly vary according to the device. Overall failure rate was 4.8%, with high puncture site, morbid obesity, previous total anticoagulation and severe calcification being related to worse efficiency results. Major complications occurred in 15 patients (0.6%). All patients were evaluated before discharge from the hospital, and were scheduled to return for ambulatory follow-up visits at 30 days postoperatively. Control duplex ultrasonography was performed on a regular basis, or within this period in case of clinical complain/signs.
Vascular closure devices proved to be safe and effective in this study. Additional prospective randomized studies are recommended.