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Updated: May 13, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Arterial closure devices. What device for which clinical situation?]
M Treitl1, K M Eberhardt, D Maxien
1Institut für Klinische Radiologie, Klinikum Innenstadt der Ludwig-Maximilians-Universität München, Medizinische Poliklinik, Pettenkoferstrasse 8a, Munich, Germany. Marcus.Treitl@med.uni-muenchen.de
Insights
Vascular closure devices offer immediate and stable access site closure after endovascular procedures, improving safety and patient comfort. These devices are crucial for patients on anticoagulants and in outpatient settings.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Medical Device Technology
Context:
- Endovascular catheterization frequently leads to access site complications, necessitating open surgery.
- The demand for rapid and secure access site closure is rising due to increased procedure volume and patients on anticoagulants.
Purpose:
- To evaluate the role and benefits of arterial vascular closure devices in managing endovascular catheterization access sites.
- To compare device-based closure with traditional manual compression methods.
Summary:
- Arterial vascular closure devices provide immediate and stable closure of arterial puncture sites following endovascular procedures.
- These devices utilize various mechanisms like sutures, occluding devices, or glues to seal the access channel.
- Clinical trials have demonstrated the safety and efficacy of these devices, particularly for large-lumen access and patients on anticoagulation therapy.
Impact:
- Vascular closure devices enhance patient safety and comfort by reducing complications and the need for prolonged bed rest.
- They facilitate outpatient procedures and are essential for managing patients with complex anticoagulation regimens.
- These devices represent a significant advancement in interventional cardiology, offering a valuable alternative to surgical repair.
Clinical/Methodical Issue:
Access site complications after endovascular catheterization sometimes require open surgery and negatively impair safety, patient comfort and reimbursement. Increasing numbers of procedures and patients with multiple anticoagulants as well as cost pressure explain the demand for an immediate and stable access site closure.
Standard Radiological Methods:
Manual compression followed by compression bandage and bed rest for 4-24 h is still the gold standard but is unable to prevent access site complications in all cases.
Methodical Innovations:
Arterial vascular closure devices allow immediate and stable closure of the puncture channel either by suture or by implantation of occluding foreign bodies or gluing fluids.
Performance:
The safety has been proven in several clinical trials. The main advantage lies in closing large lumen access sites without surgery and in patients treated with multiple anticoagulants as well as in outpatient procedures.
Achievements:
They have become a valuable supplement to the interventional arsenal.
Practical Recommendations:
The physician, however, has to decide between different systems and mechanisms with respect to patient constitution, selected access vessel and level of calcification and diameter. Furthermore, all systems require a defined training prior the first use.
