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Efficacy and safety of the angioseal vascular closure device post antegrade puncture
S Looby1, A N Keeling, A McErlean
1Department of Radiology, Beaumont Hospital, Dublin 9, Ireland.
Insights
The Angioseal vascular closure device effectively and safely achieves hemostasis after common femoral artery (CFA) antegrade puncture for lower limb interventions. This study confirms its efficiency, with no major complications reported in patients undergoing vascular procedures.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Antegrade puncture of the common femoral artery (CFA) is a common access route for lower limb vascular interventional procedures.
- Ensuring rapid and safe hemostasis is crucial for patient recovery and reducing complications.
- Vascular closure devices (VCDs) offer an alternative to manual compression for achieving hemostasis.
Purpose of the Study:
- To evaluate the efficacy and safety of the Angioseal VCD for achieving hemostasis following antegrade CFA puncture.
- To assess complication rates and patient discharge times associated with Angioseal use in this context.
Main Methods:
- Retrospective analysis of medical records for 60 consecutive patients undergoing lower limb vascular interventions via antegrade CFA puncture.
- Evaluation of hemostasis achieved by Angioseal VCD versus manual compression.
- Documentation of procedural success, complications, and discharge times.
Main Results:
- Successful antegrade puncture was achieved in 96.6% of patients.
- Angioseal achieved hemostasis in 46 patients; manual compression was used in 12 due to specific clinical factors.
- No major complications were recorded in the Angioseal group, even with concomitant antiplatelet/anticoagulant therapy.
- 50% of patients in the Angioseal group were discharged within 24 hours.
Conclusions:
- The Angioseal vascular closure device is a safe and effective method for achieving hemostasis after antegrade common femoral artery puncture.
- Its use is associated with a low complication rate and facilitates early patient discharge.
- Angioseal demonstrates reliability even in patients with prior ipsilateral CFA interventions.
Abstract:
In this study, the efficacy and safety of the Angioseal vascular closure device post antegrade puncture of the common femoral artery (CFA) for lower limb vascular interventional procedures are evaluated. A retrospective analysis of the medical records of 60 consecutive patients who were referred for interventional procedures in the superficial femoral artery (SFA) or popliteal artery (popl. art.) was performed. Antegrade puncture was successfully performed in 58 of 60 patients (96.6%). Indications included right SFA angioplasty (n = 35), left SFA angioplasty (n = 17), right popl. art. angioplasty (n = 5), and left popl. art. angioplasty (n = 1). Hemostasis was achieved by, on an intention-to-treat basis, the Angioseal vascular closure device in 46 patients and manual compression in 12 patients. Manual compression was used instead of Angioseal because of severe calcified arterial wall plaques (n = 7), failed deployment of the Angioseal (n = 4), and left SFA dissection (n = 1). There were no major recorded complications in the Angioseal group despite the use of antiplatelet or anticoagulant medications. Twenty-three (50%) of the patients in the Angioseal group were discharged within 24 h. Thirty-seven of the 46 patients who received an Angioseal device had undergone a previous ipsilateral CFA puncture (time range, 2 days to 56 months; mean, 6.2 months). Nine of these patients had undergone ipsilateral Angioseal deployment in the previous 3 months. We conclude that the Angioseal vascular closure device is a safe and efficient means of achieving hemostasis post antegrade puncture.
