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Histopathologic observations of femoral closure devices: understanding the differences
1Janey Briscoe Center of Excellence in Cardiovascular Research, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Insights
Arteriotomy closure devices speed recovery after angiography. While generally safe, potential complications like bleeding or inflammation exist, though long-term vessel appearance remains unaffected in animal studies.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Biomaterials Science
Background:
- Arteriotomy closure devices accelerate patient ambulation post-angiography.
- These devices offer advantages over manual compression, including reduced closure time and improved comfort.
- However, severe complications can arise, necessitating further evaluation.
Purpose of the Study:
- To assess the impact of arteriotomy closure devices on vascular healing.
- To compare the incidence of complications associated with different closure device types.
- To evaluate long-term angiographic outcomes in animal models.
Main Methods:
- Utilized animal models to investigate vascular responses to arteriotomy closure devices.
- Monitored for vascular spasm, inflammation, and bleeding post-procedure.
- Conducted late-term angiographic assessments at 30-60 days.
Main Results:
- Mild to moderate vascular spasm was observed initially, resolving over time.
- Early inflammation was noted, particularly with suture-based and collagen-based devices.
- Extravascular clip procedures showed less initial inflammation compared to other types.
Conclusions:
- Arteriotomy closure devices effectively expedite ambulation and patient comfort.
- While early complications like spasm and inflammation occur, they are manageable.
- No significant long-term adverse angiographic differences were detected between device types in animal models.
Abstract:
Arteriotomy closure devices have been widely employed to expedite ambulation in patients undergoing diagnostic coronary angiography or percutaneous angioplasty. As compared with manual compression, these devices decrease time to complete vessel closure, allow earlier ambulation, and improve overall patient comfort. When complications occur, they are often severe and include vascular occlusion, significant bleeding, or inflammatory changes. Animal models have been used to evaluate the impact of these devices. In animal studies, the initial procedure seems to incite mild to moderate vascular spasm that resolves at an undetermined time after the initial procedure. Inflammation occurs early and is most prominent in suture-based and collagen-based procedures compared with extravascular clip procedures. At late time points (after 30 to 60 days), however, no significant differences in angiographic appearance of the vessels could be determined.
