Application of gelatin sponge sandwich as a hemostatic aid to percutaneous suture-mediated arteriotomy closure

Suture-mediated closure devices are increasingly used for closure of large arteriotomies, such as those required for endovascular aortic repair. One of the commonly encountered situations is persistent arteriotomy oozing after successful closure requiring manual compression. The purpose of this report is to describe a simple adjunctive technique that allows a hemostatic agent (such as gelatin sponge) to be "railroaded" onto the arteriotomy site over the sutures of the closure device, thus facilitating hemostasis.