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Updated: Jul 29, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Use of a percutaneous arterial suture device (Perclose) in patients undergoing percutaneous balloon aortic
1Department of Medicine, Division of Cardiology, Cardiovascular Research Institute, University of California, San Francisco Medical Center, San Francisco, California 94143-0124, USA. andrewm@itsa.ucsf.edu
Insights
The "Preclose" technique for femoral arteriotomy closure after balloon aortic valvuloplasty is feasible. This method significantly reduces vascular complications in patients with severe aortic stenosis undergoing this procedure.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
Background:
- Percutaneous balloon aortic valvuloplasty (BAV) treats severe aortic stenosis in non-surgical candidates.
- High restenosis and morbidity from large femoral arteriotomies limit BAV effectiveness.
Purpose of the Study:
- To assess the feasibility and vascular complication rate of the "Preclose" technique for femoral arteriotomy closure during BAV.
Main Methods:
- Evaluated 18 consecutive patients undergoing BAV with the "Preclose" technique.
- Assessed immediate and 30-day outcomes, including vascular complications and hemostasis.
Main Results:
- BAV significantly reduced mean aortic valve pressure gradient (55 to 30 mmHg).
- The "Preclose" technique achieved immediate hemostasis in all patients.
- No local vascular complications or need for blood transfusion occurred.
Conclusions:
- The "Preclose" technique is a feasible approach for femoral arteriotomy closure after BAV.
- This technique is associated with low periprocedural and short-term vascular complication rates.
Abstract:
Percutaneous balloon aortic valvuloplasty has been used as a therapeutic option for patients with severe aortic stenosis who are not candidates for aortic valve replacement. This procedure has been limited by both the high rate of aortic valve restenosis and high procedural morbidity related chiefly to the large femoral arteriotomies required. The purpose of this study was to assess the feasibility and vascular complication rate using the "Preclose" technique in patients undergoing balloon aortic valvuloplasty. We evaluated the immediate and 30-day results in 18 consecutive patients undergoing this procedure. Angiographically significant peripheral vascular disease was present in 39% of cases. Aortic balloon dilation produced significant decreases in the mean aortic valve pressure gradient from 55 +/- 20 mmHg to 30 +/- 22 mmHg (P < 0.001). Closure of the arteriotomy with an 8F (10F in 1 case) Perclose device led to immediate hemostasis in all patients. Perclose of the contralateral femoral arterial site with a 6F device was attempted in 50%, all of which were successful. The mean length of bed rest was 4.5 +/- 0.9 hr. No procedural was observed. No patient had a local vascular complication, and no patient required blood product transfusion after the procedure. The use of the "Preclose" technique for closure of femoral arteriotomies after balloon aortic valvuloplasty is feasible and associated with a low rate of periprocedural and short-term vascular complications.
