To plug or not to plug?

Joseph Varon1, Robert E Fromm

  • 1The University of Texas Health Science Center, St Luke's Episcopal Hospital, Houston, Texas, USA. Joseph.Varon@uth.tmc.edu

Insights

Arterial puncture-closing devices offer minimal benefits over manual compression for percutaneous coronary interventions. More research is needed to confirm their effectiveness in managing coronary artery disease patients.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Coronary artery disease (CAD) is a significant health concern in industrialized nations.
  • Percutaneous coronary interventions (PCIs) commonly use the femoral artery approach.
  • Arterial closure devices (ACDs) aim to reduce complications and recovery time after PCI.

Discussion:

  • A recent meta-analysis indicated limited advantages of ACDs compared to manual compression.
  • The clinical significance of these marginal benefits requires further investigation.
  • Standardization of study designs is crucial for reliable comparisons.

Key Insights:

  • ACDs provide only marginal benefits over manual compression for femoral artery access.
  • Current evidence does not strongly support routine use of ACDs over manual compression.
  • The cost-effectiveness and safety profiles need additional evaluation.

Outlook:

  • Further high-quality randomized controlled trials are essential.
  • Research should focus on specific patient populations and procedural variations.
  • Long-term outcomes and complication rates associated with ACDs warrant investigation.

Related Concept Videos

Design Example: Automobile Ignition System01:14

Design Example: Automobile Ignition System

The automobile's ignition system plays a vital role by ensuring the timely ignition of the fuel-air mixture in each cylinder. This ignition is facilitated by a spark plug, which is composed of two electrodes separated by an air gap. A spark forms across this air gap when a substantial voltage is generated between the electrodes, leading to the ignition of the fuel.
One can generate a large voltage using a car battery of 12 volts with the help of inductors. Inductors are known for opposing rapid...
Formation of the Platelet Plug01:22

Formation of the Platelet Plug

The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
Patch Clamp01:18

Patch Clamp

Many fundamental cell functions such as muscle contraction and nerve transmission rely on the electrical signals produced by the movement of positively and negatively charged ions across the cell membrane. One competent method to record current flowing across the whole cell or single ion channel is the patch-clamp technique.
In this method, a glass micropipette containing electrolyte solution is tightly sealed against a small portion of the cell membrane. As a result, a patch of the cell...
Household Wiring And Electrical Safety01:13

Household Wiring And Electrical Safety

Companies that supply power to most modern households use three conductors, typically called a three-wire line. While one is neutral, the other two are both at 120 V but with opposite polarity, giving a voltage of 240 V between them. With a three-wire line, high-power appliances that require 240 V, such as electric stoves and clothes dryers, are linked between the two hot lines. 120 V appliances can be connected between the neutral and either of the hot lines. The neutral side, which is always...
Electrical Power01:07

Electrical Power

Electric power is the product of current and voltage, represented in units of joules per second, or watts. For example, cars often have one or more auxiliary power outlets with which you can charge a cell phone or other electronic devices. These outlets may be rated at 20 amps and 12 volts, so that the circuit can deliver a maximum power of 240 watts. Consider a 25 Watt bulb and a 60 Watt bulb. The conversion of electrical energy produces heat and light, while the kinetic energy lost by the...
The Joule and Joule–Thomson Experiments01:23

The Joule and Joule–Thomson Experiments

Consider an adiabatic system composed of two chambers, A and B, designed such that no heat flows into or out of the system. Initially, chamber A is filled with a gas at a fixed temperature T1, pressure p1, and volume V1, while chamber B is evacuated. The gas is then gradually forced through a rigid, porous barrier to chamber B, ultimately reaching temperature T2, pressure p2, and volume V2. A piston on the right side maintains a constant pressure (p2), which is lower than p1. The significant...