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Comparison of collagen-based vascular closure devices in patients with vs. without severe peripheral artery disease

Kaffer Kara1, Philip Kahlert, Amir A Mahabadi

  • 11 Department of Cardiology, West-German Heart Center Essen, University of Duisburg-Essen, Germany.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|February 8, 2014
PubMed

Insights

Collagen-based vascular closure devices (VCDs) showed similar complication rates in patients with and without peripheral artery disease (PAD). However, PAD patients experienced more severe complications requiring surgical repair.

Area of Science:

  • Cardiovascular Interventions
  • Vascular Access Management

Background:

  • Femoral artery access is common for endovascular procedures.
  • Peripheral artery disease (PAD) may influence vascular closure device (VCD) safety.
  • Collagen-based VCDs are widely used for achieving hemostasis.

Purpose of the Study:

  • To compare complication rates of a collagen-based VCD in patients with versus without significant PAD.
  • To assess the safety and efficacy of VCDs in diverse patient populations undergoing lower limb endovascular procedures or percutaneous coronary interventions (PCI).

Main Methods:

  • Prospective study of 382 patients undergoing lower limb endovascular procedures (PAD group, n=132) or PCI (n=250).
  • Hemostasis achieved using a collagen-based VCD (Angio-Seal).
  • Significant PAD excluded in PCI group via ankle-brachial index; major in-hospital complications recorded.

Main Results:

  • Low and similar rates of major complications observed: 1.5% in PAD group vs. 1.2% in PCI group (p=1.0).
  • No significant difference in VCD efficacy between groups (99.2% vs. 100%, p=0.35).

Conclusions:

  • Collagen-based VCDs demonstrate comparable safety and efficacy in patients with and without severe lower limb PAD.
  • Complications in the PAD group, though infrequent, were more severe and necessitated surgical intervention.
Abstract

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