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Vascular closure device failure in contemporary practice.

Venkatesan D Vidi1, Michael E Matheny, Usha S Govindarajulu

  • 1Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

JACC. Cardiovascular Interventions
|August 25, 2012
PubMed
Summary
This summary is machine-generated.

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Vascular closure device (VCD) failure rates differ by device type and are linked to increased vascular complications. Nitinol clip-based VCDs showed the highest failure rates and risk of complications.

Area of Science:

  • Cardiovascular Interventions
  • Medical Device Technology

Background:

  • Vascular closure devices (VCDs) are widely used after percutaneous coronary interventions to improve patient outcomes.
  • Limited data exist on VCD failure rates and their association with vascular complications.

Purpose of the Study:

  • To determine the frequency and predictors of VCD deployment failure.
  • To assess the association between VCD failure and vascular complications for three common VCD types.

Main Methods:

  • Analysis of 23,813 interventional coronary procedures using collagen plug-based, nitinol clip-based, or suture-based VCDs.
  • VCD failure defined as unsuccessful deployment or failure to achieve immediate hemostasis.
  • Propensity score-adjusted analysis to compare VCD failure risks and complication rates.

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Main Results:

  • Overall VCD failure rate was 3.3%, with nitinol clip-based (9.5%) and suture-based (6.1%) devices having higher failure rates than collagen plug-based (2.1%).
  • VCD failure significantly increased the risk of any, major, and minor vascular complications.
  • Nitinol clip-based and suture-based VCDs showed increased odds of failure compared to collagen plug-based VCDs.

Conclusions:

  • VCD failure rates vary significantly by device type.
  • VCD failure is a strong predictor of vascular complications, emphasizing the importance of device selection and deployment success.