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Usefulness of a Nonsuture Closure Device in Patients Undergoing Diagnostic Coronary and Peripheral Angiography
John T Owens1, Shaun Bhatty1, Robert J Donovan1
1Department of Medicine, McGuire VA Medical Center, Virginia Commonwealth University, Richmond, Virginia.
Insights
The Catalyst vascular closure device did not increase major complications but was linked to more overall complications compared to manual compression after angiography. Patients using the device ambulated sooner.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Vascular access site complications are common after diagnostic angiography.
- Femoral access is frequently used for these procedures.
- Effective methods for vascular closure are crucial to minimize complications and improve patient recovery.
Purpose of the Study:
- To compare the complication rates of the Catalyst vascular closure device versus manual compression.
- To evaluate the safety and efficacy of the Catalyst device in patients undergoing diagnostic angiographic procedures.
- To assess the impact of the Catalyst device on patient ambulation time.
Main Methods:
- A study of 1,470 patients undergoing diagnostic coronary and peripheral angiography via femoral access.
- Comparison between patients who received the Catalyst closure device (436) and those managed with manual compression (1,034).
- Analysis of major and any complication rates, adjusted for confounding variables and propensity scores.
Main Results:
- No significant difference in major complications between the Catalyst device (0.9%) and manual compression (1.4%) (p=0.49).
- A significantly higher rate of any complications was observed with the Catalyst device (11.7%) compared to manual compression (6.2%) (p<0.01).
- Patients using the Catalyst device ambulated significantly sooner (2 hours) than those with manual compression (6 hours).
Conclusions:
- The Catalyst vascular closure device is not associated with an increased risk of major groin complications.
- The Catalyst device is associated with a higher risk of any complications compared to manual compression.
- Earlier ambulation is a benefit for patients treated with the Catalyst device.
Abstract:
Vascular access site complications can follow diagnostic coronary and peripheral angiography. We compared the complication rates of the Catalyst vascular closure device, with the complication rates after manual compression in patients undergoing diagnostic angiographic procedures via femoral access. We studied 1,470 predominantly male patients undergoing diagnostic coronary and peripheral angiography. Catalyst closure devices were used in 436 (29.7%) patients and manual compression was used in 1,034 (70.3%) patients. The former were allowed to ambulate after 2 hours, while the latter were allowed to ambulate after 6 hours. Major complications occurred in 4 (0.9%) patients who had a Catalyst device and in 14 (1.4%) patients who had manual compression (odds ratio [OR]: 0.67, 95% confidence interval [CI]: 0.22-2.1, p = 0.49). Any complications occurred in 51 (11.7%) patients who had a Catalyst closure device and in 64 (6.2%) patients who had manual compression (OR: 2, CI: 1.4-3, p < 0.01). After adjustment for other variables and for a propensity score reflecting the probability to receive the closure device, the association of major complications with the use of the closure device remained not significant (OR: 0.54, 95% CI: 0.17-1.7, p = 0.29), while the association of any complications with the use of the Catalyst device remained significant (OR: 1.9, 95% CI: 1.3-2.9, p < 0.01). The Catalyst device was not associated with an increased risk of major groin complications but was associated with an increased risk of any complications compared with manual compression. Patients receiving the closure device ambulated sooner.
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