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Published on: May 26, 2023
[Vascular complications at the femoral access: impact of the percutaneous closure device Perclose]
M-C Mboup1, B Moquet1, A Zabalawi1
1Service de cardiologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22027 Saint-Brieuc, France.
Insights
The Perclose device offers safe and effective femoral access site closure in interventional cardiology, with a high success rate and low severe bleeding risk. Device failure, however, significantly increases bleeding complications.
Area of Science:
- Cardiology
- Vascular Surgery
Context:
- Femoral access site complications are a significant source of morbidity in interventional cardiology procedures.
- Percutaneous closure devices aim to reduce these complications.
Purpose:
- To evaluate the efficacy and safety of the Perclose percutaneous closure device for femoral access sites.
- To assess bleeding complications in relation to antithrombotic therapy and device deployment success.
Summary:
- A study of 375 patients using the Perclose system for femoral access closure showed a 97.3% success rate.
- The overall rate of severe bleeding was 1%, with minor and moderate bleeding at 4.2% and 0.5% respectively.
- Failure to successfully deploy the closure device significantly increased the risk of bleeding complications (4.3% to 60%).
Impact:
- The Perclose system demonstrates a low rate of severe bleeding, enhancing patient safety during interventional cardiology procedures.
- Highlighting the importance of successful device deployment to minimize post-procedural bleeding risks.
Introduction:
Vascular complications at the femoral access site is an important factor of morbidity. The aims of this study were to evaluate the efficacy and safety of the percutaneous closure device (Perclose) during interventional cardiology procedures.
Patients And Methods:
All patients with percutaneous closure of the femoral access site by the Perclose system in 2010 were included. We evaluated the indications of the procedures, the success rate of implantation and the bleeding complications according to antithrombotic therapy used.
Results:
Three hundred and seventy five patients underwent a percutaneous closure by the Perclose system. Acute coronary syndromes with or without elevation of ST segment were the main indications of procedures (74.9%). The success rate of percutaneous closure of the femoral access site was 97.3%. The rate of minor, moderate, and severe bleeding of the entire cohort according to the GUSTO classification was respectively 4.2%, 0.5% and 1%. Bleeding complications were similar in both groups of patients (2.1% vs 7% P=0.122). In case of unsuccessful deployment of femoral closure devices, the risk of bleeding complications range from 4.3% to 60% (P=0.0000036).
Conclusion:
The use of the Perclose system is associated with a low rate of severe bleeding at the femoral access site. However, the failures of percutaneous closure increase the risk of bleeding complications.
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