Related Experiment Videos
Infectious and ischemic complications from percutaneous closure devices used after vascular access
Umar S Boston1, Jean M Panneton, Janet M Hofer
1Division of Vascular Surgery, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Insights
Percutaneous closure devices (PCDs) used after vascular access may increase surgical complications. Patients needing surgery after PCD use face higher risks of infection and limb ischemia compared to manual compression.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Complications
Background:
- Percutaneous vascular access (PVA) is common for procedures.
- Arteriotomy site closure is critical to prevent complications.
- Percutaneous closure devices (PCDs) offer an alternative to manual compression.
Purpose of the Study:
- To compare surgical intervention outcomes.
- To assess complications between PCDs and manual compression.
- To identify risks associated with PCDs in PVA.
Main Methods:
- Retrospective study of 56 patients requiring surgery post-PVA.
- Comparison between patients who received PCDs (Group I, n=15) and manual compression (Group II, n=41).
- Analysis of operative indications: pseudoaneurysm, hemorrhage, infection, limb ischemia.
Main Results:
- PCD use was associated with increased infectious complications.
- PCD use correlated with higher rates of limb ischemia.
- Surgical repair was more complex in the PCD group.
Conclusions:
- Patients requiring surgery after PVA with PCDs have elevated risks.
- PCDs may lead to greater infectious and ischemic complications.
- Complex vascular repair is more frequent when PCDs are used.
Abstract:
The introduction of percutaneous closure devices (PCDs) to seal arteriotomy sites following percutaneous vascular access (PVA) can lead to greater complications than those with manual compression. The aim of this study was to compare complications and outcome between patients requiring surgery after receiving a PCD and those undergoing standard manual compression. This retrospective study evaluated 56 patients (mean age, 63 years) requiring surgical intervention from January 1, 1998 to April 30, 2002, following complications of PVA. Operative indications were pseudoaneurysm, hemorrhage, infectious complications, and limb ischemia. Patients were divided into two groups for comparison: group I (n = 15, PCD) and group II (n = 41, no PCD). In group 1 patients there were 18 limbs in which 20 Perclose devices were used and 1 limb in which a Duett device was used. From the outcomes in these two groups we concluded that patients undergoing surgical intervention following complications of PVA are at a significantly increased risk for infectious and ischemic complications and require more complex vascular repair when percutaneous closure devices are used.