Single-center comparison of the efficacy and complications of arterial vascular closure devices in interventional radiology. Issue 4 (July 2017)

• Record Type: Journal Article
• Authors: Elmasri, Matthew A.; Kee, Stephen T.; Moriarty, John M.; Gomes, Antoinette; Lee, Edward W.; McWilliams, Justin P.
• Is Part Of: Journal of vascular access. Volume 18:Issue 4(2017)
• Page Start: 339
• Page End: 344
• Publication Date: 2017-07
• Subjects: Arterial access -- Arteriotomy -- Hemostasis -- Manual compression -- Vascular access -- Vascular closure device; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.5301/jva.5000623
• Languages: English
• ISSNs: 1129-7298

Abstract

Introduction: Vascular closure devices (VCDs) are commonly used to achieve hemostasis of arterial access sites, but there is little comparative data on the variety of VCDs currently in clinical use. We reviewed the VCD experience at our institution to determine the safest and most effective VCD. Materials and Methods: Retrospective analysis of 907 consecutive arterial procedures in interventional radiology from June 2012 to June 2014 was performed. Five VCDs were used: Angio-Seal (n = 478), FISH (n = 56), Mynx (n = 56), Perclose (n = 61), and Starclose (n = 68). Patients who underwent manual compression (n = 188) without use of VCDs were also studied as a comparison group. Patient demographics and pre-procedural laboratory parameters were recorded. The technical success rate for achievement of hemostasis and complication rates were noted. Results: Complete hemostasis rate (aka technical success rate) was 93.5% for Angio-Seal, 83.9% for FISH, 53.6% for Mynx, 73.7% for Perclose, 76.5% for Starclose, and 91.5% for manual compression. The differences among the devices were statistically significant (p<0.001). Fourteen major complications (1.5%) were encountered: nine with Angio-Seal (1.9%), one with Mynx (1.8%), one with Starclose (1.5%), and three with manual compression (1.6%); these differences were not statistically significant. Of the demographic and laboratory parameters studied, none were significantly correlated with hemostasis failure or development of complications. Conclusions: In our single-center institutional experience, Angio-Seal is the device with the best technical success rate. Major complications of VCDs were rare, with no statistically significant difference between devices.