Intentional combination of ProGlide and Angio-Seal for femoral access haemostasis in transcatheter aortic valve replacement. (15th October 2019)

• Record Type: Journal Article
• Authors: Ko, Tsung-Yu; Kao, Hsien-Li; Liu, Ying-Ju; Yeh, Chih-Fan; Huang, Ching-Chang; Chen, Ying-Hsien; Hung, Chi-Sheng; Chan, Chih-Yang; Lin, Lung-Chun; Chen, Yih-Sharng; Lin, Mao-Shin
• Is Part Of: International journal of cardiology. Volume 293(2019)
• Page Start: 76
• Page End: 79
• Publication Date: 2019-10-15
• Subjects: Vascular closure -- Vascular complication -- TAVR; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.05.055
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: To describe and evaluate the intentional combination of Angio-Seal (AS) and Perclose ProGlide (PP) in achieving haemostasis in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). Methods: This study cohort was divided into two groups: dual PP versus one AS with one PP (AS + PP) used for common femoral artery haemostasis. The baseline, procedural characteristics and all outcomes (defined according toVARC-2 criteria) were prospectively collected and retrospectively compared. Results: Overall, a total of 151 consecutive patients (68 men; 80.9 ± 7.3 years old) were evaluated. Of these, 51 patients (33.8%) underwent TAVR using the dual PP, and 100 (66.2%) using one AS with one PP. There were no significant differences in the baseline characteristics of both patient groups, except higher incidence of chronic pulmonary disease in dual PP group (21.6% vs 7%, P = 0.009). Patients in AS + PP group had lower rate of arterial stricture (21.6% vs 8%, P = 0.017), arterial dissection (13.7% vs 4.0%), requiring endovascular intervention for puncture site issues (21.6% vs 9.0%, P = 0.031). Less procedural time (139.8 ± 36.9vs97.9 ± 31.4 min, P < 0.001) & contrast medium consumption (223.9 ± 88.3vs174.1 ± 49.7 ml, P < 0.001) were also observed in AS+PP group. There were no statistically significant differences between 2 groups in regards of closure device failure, major and minor vascular complications, nor major and minor bleeding. Conclusions: Intentional combination of one PP and one AS for femoral access haemostasis in patients undergoing TAVR is feasible and safe, with low risk of vascular and bleeding complications. Highlights: We evaluated the intentional combination of Angio-Seal and Perclose ProGlide for vascular closure during transfemoral TAVR This hybrid procedure had low rate of arterial stricture/dissection and requiring further endovascular intervention. It would be an optimal choice of haemostatic procedure for TAVR, especially in patients with relatively small vessel size.