Large Bore Vascular Access Closure Device Strategies. Issue 2 (4th March 2021)

• Record Type: Journal Article
• Authors: Sarathy, Kiran; Patel, Kush P.; Jones, Daniel Mark; Akhtar, Mohammed; Khanna, Vikram; Broyd, Chris; Ozkor, Mick; Kennon, Simon; Mathur, Anthony; Baumbach, Andreas; Mullen, Michael
• Is Part Of: Structural heart. Volume 5:Issue 2(2021)
• Page Start: 186
• Page End: 191
• Publication Date: 2021-03-04
• Subjects: Vascular closure device -- ProGlide -- Angio-Seal -- MANTA -- TAVR; Heart -- Diseases -- Periodicals; Congenital heart disease -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular Diseases; Cardiovascular system -- Diseases; Congenital heart disease; Heart -- Diseases; Periodicals; 616.12
• DOI: 10.1080/24748706.2021.1872818
• Languages: English
• ISSNs: 2474-8706

Abstract

ABSTRACT: Background : The optimal strategy for large bore vascular closure following TAVR is a matter of contention as major bleeding and vascular complications remain a challenge. We compared three strategies for post-TAVR vascular closure in terms of safety and efficacy: a dual ProGlide-based strategy, a hybrid strategy of ProGlide and Angio-Seal, and a MANTA strategy. Methods : Patients were enrolled in one of the three strategies: two ProGlides, a single ProGlide with an 8 F Angio-Seal, or a single 18 F MANTA. Results : In total, 172 patients were enrolled in this study: 86 in the MANTA group, 40 in the ProGlide/Angio-Seal group, 46 in the dual ProGlide group. Hemostasis was achieved in 95% of patients. MANTA was associated with vessel occlusion in 2% of cases. The dual ProGlide group required an extra device to achieve hemostasis in 35% of cases. Conclusion : The three strategies of MANTA, dual ProGlides, or ProGlide/Angio-Seal are all effective, but there are important differences between them which mandate careful consideration by operators. Abbreviations: TAVR: Transcatheter Aortic Valve Replacement; VCD: Vascular Closure Device; CT: Computed Tomography; DSA: Digital Subtraction Angiography