Premium
Preclosure of large‐sized venous access sites in adults undergoing transcatheter structural interventions
Author(s) -
Hamid Tahir,
Rajagopal Rajinikanth,
Pius Charlene,
Clarke Bernard,
Mahadevan Vaikom S.
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24358
Subject(s) - medicine , venous access , surgery , fibrous joint , vascular closure device , femoral vein , vein , fistula , venous thrombosis , femoral artery , thrombosis , catheter
Background Patients requiring congenital and structural heart interventions often require large‐sized sheath insertion into femoral veins and arteries. Clinical outcome data on the use of suture‐mediated devices for femoral venous access site closure are limited. Objective To assess the efficacy and safety of the Perclose™ (Abbott Vascular Devices, CA) suture‐mediated device using the preclosure technique, in achieving haemostasis at femoral venous access site following large sheath insertion (≥8 Fr). Design and Setting Two hundred and forty‐three consecutive patients underwent 310 access site closures with the Perclose™ device using the preclosure technique. There were 151 (62%) women, mean age 43 (±16) years. 234/243 (96%) received heparin. Mean venous access site sheath diameter was 11.5 (±3) Fr. Results Immediate haemostasis (<2 min) was achieved in 304/310 (98%) sites. No patients had major complications. Short‐term follow‐up at 3 months revealed no evidence of haematoma or fistula formation or clinical evidence of vessel occlusion. On medium‐term clinical follow‐up (mean follow‐up of 14 ± 12 and median of 12.4 months), no complications were seen at the venous access sites. Conclusion Preclosure of large‐size femoral venous access sheath sites using the suture‐mediated Perclose™ device is efficacious in achieving rapid haemostasis in the presence of anticoagulation in the venous site. On 1‐year follow‐up, there was no clinical evidence of vascular complications in the venous access sites. © 2012 Wiley Periodicals, Inc.