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Updated: Jan 30, 2026

Engineering Platform and Experimental Protocol for Design and Evaluation of a Neurally-controlled Powered Transfemoral Prosthesis
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Validation of an extrinsic compression and early ambulation protocol after diagnostic transfemoral cerebral

Daniel A Tonetti1,2, Christopher Ferari3, Jennifer Perez1

  • 1Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Journal of Neurointerventional Surgery
|January 25, 2019
PubMed

Insights

A standardized femoral closure protocol involving manual compression and bedrest proved safe and effective for transfemoral cerebral angiography, achieving >99% hemostasis regardless of antiplatelet use.

Area of Science:

  • Neurology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Access-site complications are a significant concern in transfemoral cerebral angiography.
  • Current femoral closure practices lack standardization, leading to variable outcomes.
  • Antiplatelet medication use further complicates femoral access management.

Purpose of the Study:

  • To validate the efficacy and safety of a standardized femoral closure strategy.
  • To assess the protocol's effectiveness across all diagnostic transfemoral angiograms.
  • To determine if the protocol is effective regardless of antiplatelet regimen.

Main Methods:

  • A single-arm prospective cohort study enrolled 525 patients undergoing diagnostic transfemoral cerebral angiography.
  • A standardized closure protocol included 20 minutes of manual compression and 2 hours of bedrest.
  • Patients were stratified based on antiplatelet medication use; primary outcome was hematoma or oozing.

Main Results:

  • Hemostasis was achieved in >99% of cases (5 patients with primary outcome).
  • No significant differences in outcomes were observed between patients on and not on antiplatelets.
  • No instances of delayed hematoma, pseudoaneurysm, or arteriovenous fistula were reported.

Conclusions:

  • A standardized femoral closure protocol using manual compression and bedrest is safe and effective.
  • This protocol ensures successful hemostasis in over 99% of transfemoral angiograms.
  • The protocol's efficacy is independent of the patient's antiplatelet strategy.
Abstract

Keywords:
angiographystandardstechnique

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