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Use of vascular closure device is safe and effective in electrophysiological procedures
Ilir Maraj1, Adam S Budzikowski, Waleed Ali
1Division of Cardiovascular Medicine-EP Section, SUNY Downstate, 450 Clarkson Ave, Box 1199, Brooklyn, NY, 11203, USA.
Insights
Vascular closure devices (VCDs) effectively and safely closed multiple venous access sites in patients undergoing electrophysiological procedures, even when using arterial devices for venous closure.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Electrophysiology
Background:
- Vascular closure devices (VCDs) are commonly used after arterial access procedures.
- Their safety and efficacy in electrophysiological procedures, particularly for venous access, are less understood.
- Patients undergoing electrophysiological procedures often require anticoagulation and multiple access sites.
Purpose of the Study:
- To evaluate the utility and outcomes of collagen VCDs (Angioseal) in patients undergoing electrophysiological procedures.
- To assess the safety and effectiveness of using arterial VCDs for venous closure in this patient population.
Main Methods:
- Retrospective chart review of patients who underwent VCD deployment after electrophysiological procedures.
- Analysis of VCD deployment success rates and complication incidence.
Main Results:
- A total of 76 VCDs were deployed in 26 patients (mean 3 VCDs per patient).
- 73 VCDs were placed in femoral veins and 3 in the femoral artery.
- Successful deployment occurred in 75 out of 76 access sites, with only one case of minor ecchymosis reported.
Conclusions:
- Collagen plug-based VCDs, designed for arterial closure, can be safely and effectively used for multiple venous accesses in electrophysiological procedures.
- These devices can manage venotomies up to 2 Fr larger than the device size.
- This offers a viable option for closure in patients requiring anticoagulation and multiple access sites.
Purpose:
Little is known about the usefulness and safety of vascular closure devices (VCDs) in electrophysiological procedures. We present a retrospective analysis of our experience assessing the utility and outcomes of collagen vascular closure device (Angioseal) in patients that required periprocedural anticoagulation and multiple vascular access sites.
Methods:
An retrospective chart review of patients who have undergone the deployment of VCD following electrophysiological procedures.
Results:
In 26 patients (16 males, age 57 ± 15 years, weight 96 ± 21 kg), a total of 76 VCD were deployed. Seventy-three VCDs in femoral veins (right or left) and three in femoral artery. The mean number of VCD per patient was 3 (range, 2-4). VCD was successfully deployed in 75 out of 76 access sites. One patient was noted to have ecchymosis in both groins during follow-up visit. No other complications were noted.
Conclusions:
We provide evidence that a collagen plug-based VCD designed for arterial closure can be safely and effectively used to close multiple venous accesses even in the same vein. This can be accomplished with a venotomy size up to 2 Fr larger than the size of the closure device.
