Torque device suture technique to achieve hemostasis in large-bore venous access

Area of Science:

• Cardiovascular Interventions
• Surgical Techniques
• Vascular Access Management

Background:

• Large bore venous access is crucial for transcatheter procedures.
• Hemostasis management for venous access can be challenging and resource-intensive.
• The figure-of-eight suture technique is a common method for venous access hemostasis.

Purpose of the Study:

• To describe and compare a novel torque device modification of the figure-of-eight suture technique.
• To evaluate its efficacy in managing venous access hemostasis during ASD/PFO closure.
• To compare this novel technique against the standard figure-of-eight suture technique.

Main Methods:

• Retrospective study of 40 patients undergoing ASD or PFO closure.
• 20 patients received standard figure-of-eight suture technique.
• 20 patients received figure-of-eight suture technique with a torque device modification.
• Bleeding events categorized using Bleeding Academic Research Consortium (BARC) definitions.

Main Results:

• Groups were similar in demographics and procedural characteristics.
• Standard figure-of-eight group: 7 bleeding events (6 BARC II, 1 BARC I).
• Torque device group: 3 bleeding events (2 BARC II, 1 BARC I).
• No hematomas reported in either group.

Conclusions:

• The torque device suture technique is a novel modification for figure-of-eight sutures.
• This technique provides secure, variable suture tension and facilitates easy removal.
• It offers a potentially improved method for achieving venous hemostasis.