Preclosure of large‐sized venous access sites in adults undergoing transcatheter structural interventions. Issue 4 (8th November 2012)

• Record Type: Journal Article
• Authors: Hamid, Tahir; Rajagopal, Rajinikanth; Pius, Charlene; Clarke, Bernard; Mahadevan, Vaikom S.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 81:Issue 4(2013:Mar. 01)
• Page Start: 586
• Page End: 590
• Publication Date: 2012-11-08
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24358
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24358-sec-0001" sec-type="section"> <title>Background</title> <p>Patients requiring congenital and structural heart interventions often require large‐sized sheath insertion into femoral veins and arteries. Clinical outcome data on the use of suture‐mediated devices for femoral venous access site closure are limited.</p> </sec> <sec id="ccd24358-sec-0002" sec-type="section"> <title>Objective</title> <p>To assess the efficacy and safety of the Perclose™ (Abbott Vascular Devices, CA) suture‐mediated device using the preclosure technique, in achieving haemostasis at femoral venous access site following large sheath insertion (≥8 Fr).</p> </sec> <sec id="ccd24358-sec-0003" sec-type="section"> <title>Design and Setting</title> <p>Two hundred and forty‐three consecutive patients underwent 310 access site closures with the Perclose™ device using the preclosure technique. There were 151 (62%) women, mean age 43 (±16) years. 234/243 (96%) received heparin. Mean venous access site sheath diameter was 11.5 (±3) Fr.</p> </sec> <sec id="ccd24358-sec-0004" sec-type="section"> <title>Results</title> <p>Immediate haemostasis (<2 min) was achieved in 304/310 (98%) sites. No patients had major complications. Short‐term follow‐up at 3 months revealed no evidence of haematoma or fistula formation or clinical evidence of vessel occlusion. On medium‐term clinical follow‐up (mean follow‐up of 14 ± 12 and median of 12.4 months), no complications were seen at the venous access sites.</p> </sec> <sec id="ccd24358-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Preclosure of large‐size femoral venous access sheath sites using the suture‐mediated Perclose™ device is efficacious in achieving rapid haemostasis in the presence of anticoagulation in the venous site. On 1‐year follow‐up, there was no clinical evidence of vascular complications in the venous access sites. © 2012 Wiley Periodicals, Inc.</p> </sec> </abstract>