AI Article Synopsis
- A clinical trial assessed the Cross-Seal vascular closure device's ability to effectively and safely achieve hemostasis in patients using large sheaths (8F-18F) for interventional procedures.
- Conducted on 147 participants, the trial showed a quick average time to hemostasis of just 0.4 minutes, with high technical success (92.3%) and a low rate of major complications (5.7%).
- Results indicate that the Cross-Seal device is a safe and effective option for patients undergoing percutaneous endovascular procedures with large-bore access.
Article Abstract
Background: An increasing number of interventional procedures require large-sheath technology (>12F) with a favorable outcome with endovascular rather than open surgical access. However, vascular complications are a limitation for the management of these patients. This trial aimed to determine the effectiveness and safety of the Cross-Seal suture-mediated vascular closure device in obtaining hemostasis at the target limb access site following interventional procedures using 8F to 18F procedural sheaths.
Methods: The Cross-Seal IDE trial (Investigational Device Exemption) was a prospective, single-arm, multicenter study in subjects undergoing percutaneous endovascular procedures utilizing 8F to 18F ID procedural sheaths. The primary efficacy end point was time to hemostasis at the target limb access site. The primary safety end point was freedom from major complications of the target limb access site within 30 days post procedure.
Results: A total of 147 subjects were enrolled between August 9, 2019, and March 12, 2020. Transcatheter aortic valve replacement was performed in 53.7% (79/147) and percutaneous endovascular abdominal/thoracic aortic aneurysm repair in 46.3% (68/147) of subjects. The mean sheath ID was 15.5±1.8 mm. The primary effectiveness end point of time to hemostasis was 0.4±1.4 minutes. An adjunctive intervention was required in 9.2% (13/142) of subjects, of which 2.1% (3/142) were surgical and 5.6% (8/142) endovascular. Technical success was achieved in 92.3% (131/142) of subjects. Freedom from major complications of the target limb access site was 94.3% (83/88).
Conclusions: In selected patients undergoing percutaneous endovascular procedures utilizing 8F to 18F ID procedural sheath, Cross-Seal suture-mediated vascular closure device achieved favorable effectiveness and safety in the closure of the large-bore arteriotomy.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03756558.
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| http://dx.doi.org/10.1161/CIRCINTERVENTIONS.123.013842 | DOI Listing |
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