Objectives: To report the feasibility of a collagen-mediated closure device using a modified Angio-Seal closure technique for access site management following percutaneous balloon aortic valvuloplasty (BAV).
Background: With the advent of percutaneous aortic valve replacement therapies, there has been a resurgence of interest in BAV procedures. Vascular complications, including bleeding, are a common source of morbidity post procedure as a result of the requirement for large bore femoral artery access. The use of vascular closure devices may reduce bleeding complications.
Methods: We describe a new technique for vascular closure in this setting. At the conclusion of the valvuloplasty procedure, two 0.035'' wires are inserted through the femoral artery sheath. A conventional collagen-mediated closure device (8F Angio-Seal) is deployed over the first wire and along side the second wire. If immediate hemostasis is not achieved, a second device is loaded onto the second wire and deployed to achieve hemostasis.
Results: Percutaneous BAV was performed in 21 patients. Hemostasis was successfully achieved in all patients with either a single 8F Angio-Seal closure device (18 patients) or after placement of a second device (three patients).
Conclusions: The modified "Double Wire" Angio-Seal technique is a feasible method for hemostasis following percutaneous BAV.
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http://dx.doi.org/10.1002/ccd.22295 | DOI Listing |
PeerJ
December 2024
Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China.
Objective: This systematic review and meta-analysis aims to evaluate the effectiveness and safety of Angio-Seal and StarClose vascular closure devices (VCDs) in achieving hemostasis after interventional surgery.
Methods: Randomized controlled trials (RCTs) and observational studies comparing Angio-Seal and StarClose were identified through systematic searches. Data on vascular closure success rate, complication rates, hematoma formation, pseudoaneurysm, arterial occlusion, and surgical intervention were extracted and pooled using a random effects model.
J Endovasc Ther
December 2024
Department of Interventional Radiology, Haaglanden Medical Center, Den Haag, The Netherlands.
Ultrasound visualization of vascular closure devices during endovascular access closure leads to a significant decrease in overall and major post interventional access site complications. This non-invasive and often readily available imaging technique could therefore lead to an important decrease in morbidity and subsequent overall health care costs when added to the standard intervention protocol. With the increasing use of endovascular techniques to treat peripheral artery disease, the addition of ultrasound-techniques in closure of endovascular access sites could potentially have a large clinical impact, both on patient outcomes as well as financial outcomes.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Cardiology Division, Heart & Vessels Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Background: Endovascular treatment of peripheral arterial disease requires safe and reliable arterial access. This study evaluates the feasibility and safety of percutaneous axillary artery access for endovascular therapy. A variety of anatomic and logistic obstacles can be overcome with upper extremity access.
View Article and Find Full Text PDFBMJ Case Rep
November 2024
Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada
Different techniques and devices can achieve haemostasis after endovascular procedures to reduce time to haemostasis and facilitate percutaneous large-bore access. One such device is the Angio-Seal, which accomplishes haemostasis by compressing a collagen plug against the arteriotomy. Multiple complications related to Angio-Seal exist, most commonly acute artery occlusions and rarely infections and endarteritis.
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