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Related Experiment Video

Updated: Dec 26, 2025

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Vascular Access and Closure for Peripheral Arterial Intervention.

Andrew M Goldsweig1, Eric A Secemsky2

  • 1Division of Cardiovascular Medicine, University of Nebraska Medical Center, 982265 Nebraska Medical Center, Omaha, NE 68198, USA.

Interventional Cardiology Clinics
|March 10, 2020
PubMed
Summary

Safe vascular access for peripheral arterial interventions involves specific techniques and guidance. While closure devices offer patient comfort, they do not reduce complications compared to manual compression.

Keywords:
Closure deviceEndovascularPeripheral artery diseasePeripheral vascular interventionVascular access

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Peripheral arterial interventions necessitate secure vascular access and effective hemostasis.
  • Patient and procedural variables influence the choice of access sites, techniques, and equipment.
  • Minimizing procedural complications is paramount in endovascular procedures.

Purpose of the Study:

  • To outline optimal strategies for vascular access and closure in peripheral arterial interventions.
  • To review current methods for achieving hemostasis following arteriotomy.
  • To compare the efficacy and complication rates of different closure techniques.

Main Methods:

  • Micropuncture technique for arterial access.
  • Ultrasound and fluoroscopic guidance for precise access.
  • Utilization of the smallest feasible sheath diameter.
  • Evaluation of hemostasis methods: manual compression, device-mediated compression, intravascular, and extravascular closure devices.

Main Results:

  • Optimal arterial access involves micropuncture, imaging guidance, a compressible site, and minimal sheath size.
  • Hemostasis can be achieved through compression or closure devices.
  • Closure devices enhance patient comfort and speed up hemostasis.
  • No demonstrated reduction in complications with closure devices versus compression.

Conclusions:

  • Adherence to recommended access techniques is crucial for safety.
  • While closure devices improve convenience, compression remains a standard for effective hemostasis.
  • Further research may be needed to clarify the role of closure devices in complication reduction.