Access site management with vascular closure devices for percutaneous transarterial procedures

The rising numbers in the aging population will undoubtedly lead to a corresponding increase in percutaneous endovascular procedures to address their cardiovascular health issues. With a constant drive to develop innovative treatment methods to achieve improved treatment outcomes while reducing procedural-related complications, endovascular interventionalists have focused on technologies to provide efficient hemostatic control of femoral artery access following percutaneous diagnostic or therapeutic angiographic procedures. Compared with the traditional hemostatic method using manual compression, several arterial closure devices (ACD) have been shown to reduce time of hemostasis, enable early patient ambulation, reduce hospitalization staff use, and improve patient outcome. However, these ACDs have their shortcomings as the interventionalists need to be familiar with these technologies as well as their potential complications. This article provides a comprehensive review of current closure device technologies as well as clinical experiences with these devices. The adjunctive role of these technologies in endovascular aortic aneurysm repair is also discussed.