Related Experiment Video

Updated: Jun 3, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

Comparison of bleeding complications using arterial closure device versus manual compression by propensity matching

Drew S Allen1, Steven P Marso, Jason B Lindsey

  • 1Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.

The American Journal of Cardiology
|March 23, 2011
PubMed

Insights

Arterial closure devices (ACDs) significantly reduce major bleeding and hospital stays after percutaneous coronary intervention (PCI). ACDs are particularly beneficial for high-risk patients, showing greater reductions in bleeding events.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Arterial closure devices (ACDs) offer immediate hemostasis, enhancing patient comfort and enabling early ambulation post-percutaneous coronary intervention (PCI).
  • Evaluating ACD utilization and its impact on major bleeding after PCI in a broad patient population is crucial for optimizing care.

Purpose of the Study:

  • To assess the effectiveness of ACDs in reducing major bleeding and complications following PCI.
  • To compare outcomes between patients treated with ACDs and those managed with manual compression.

Main Methods:

  • A propensity-matched analysis was conducted on 2,324 patients undergoing PCI, comparing 1,162 patients using ACDs with 1,162 using manual compression.
  • The primary endpoint was National Cardiovascular Data Registry (NCDR) major bleeding, with secondary endpoints including bleeding stratified by risk categories, length of stay, and pseudoaneurysm rates.
  • A subgroup analysis compared suture-based ACDs versus collagen-plug ACDs.

Main Results:

  • ACD use was associated with a significant reduction in major bleeding (2.4% vs 5.2%, p <0.001) compared to manual compression.
  • High-risk patients receiving ACDs experienced the greatest reduction in major bleeds (3.1% vs 10.3%, p <0.001).
  • ACD patients showed decreased length of stay (1.9 vs 2.3 days, p = 0.007) and pseudoaneurysm rates (0.3% vs 1.1%, p = 0.028).
  • Suture-based devices had a lower composite event rate than collagen-plug devices (1.4% vs 3.4%, p = 0.048).

Conclusions:

  • Arterial closure devices are effective in reducing major bleeding and pseudoaneurysms after PCI.
  • ACD utilization is linked to a shorter hospital length of stay in PCI patients.
  • Suture-based ACDs may offer a superior safety profile compared to collagen-plug devices.

More Related Videos

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model12:00

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

Published on: November 24, 2014

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Related Concept Videos

Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...