[10 years of arterial closure devices: a critical analysis of their use after PTCA]

With worldwide over 1 million applications, vascular closure devices have been established as an essential tool of invasive cardiology. This overview compares today's four commercially available closure devices, VasoSeal (VS), Angio-Seal (AS), Perclose, Inc. (PC) and Duett (DU) for their usefulness after coronary interventions. The published data regarding deployment success rates for VS, AS, PC and DU are in the range of 88%, 91%, 90% and 98% up to 100%, respectively. Times to hemostasis were 5-13', 2-4', 11-19' and 4-14', accompanied by times to mobilization of 6-9 h, 6-8 h, 4-7 h and 2-6 h. Minor complications were described in 8%, 5.9%, 5.3% and 2.1%, major complications in 5.3%, 1.3%, 4% and 2.6%. Although none of the closure devices has been shown to reduce major local complications as compared to manual compression, all sealing devices have documented a significant reduction in time to hemostasis. The increased patient comfort is essentially related to the ability of sheath removal immediately after PTCA. Vascular closure devices reduce the burden of medical staff and decrease hospital costs by earlier discharge.