Open AccessVascular Closure Devices in Acute Coronary Syndromes: From Arbitrary to a Necessity?
Author(s) -
Dihu Jamil B.,
Chadaga Amar R.,
Sanborn Timothy A.
Publication year - 2012
Publication title -
cardiovascular therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 46
eISSN - 1755-5922
pISSN - 1755-5914
DOI - 10.1111/j.1755-5922.2010.00251.x
Subject(s) - medicine , vascular closure device , conventional pci , percutaneous coronary intervention , hemostasis , intensive care medicine , acute coronary syndrome , cardiac catheterization , vascular access , surgery , myocardial infarction , hemodialysis
SUMMARY Vascular closure devices (VCDs) were initially developed to improve access site hemostasis and allow for earlier ambulation in patients undergoing diagnostic catheterization and percutaneous coronary intervention (PCI). Though initially thought to be beneficial, large meta‐analysis has shown conflicting data regarding whether VCDs alter access site bleeding in a variety of clinical settings. One area of particular interest for the adoption of VCDs has been in the setting of acute coronary syndromes (ACS) in which multiple antiplatelet strategies are often employed leading to a high risk of bleeding. Bleeding in ACS has been shown to be a powerful independent predictor of 30‐day mortality. Recently, investigators have reported that VCDs reduce access site bleeding in the setting of ACS. In our review, we use several selected representative clinical trials to provide a historical account for the use of VCDs. We also provide for a review of data as it relates to access site bleeding in ACS along with analysis showing that VCDs may potentially provide for reductions in bleeding and vascular complications in patients with ACS undergoing PCI.