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Femoral artery access site closure with perclose suture mediated device in coronary interventions
Keshavamurthy Ganapathy Bhat1, Ratheesh Kumar Janardhanapillai2, Ajay Kumar Dabas3
1Dept of Cardiology, Command Hospital Air Force, Bangalore, India; Dept of Cardiology, Army Hospital, Delhi Cantt, India.
Insights
The Perclose Proglide (PP) device offers a safe and effective alternative to manual compression (MC) for vascular closure after coronary interventions. This method significantly reduces complications like bleeding and hematoma, with a low device failure rate.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Devices
Background:
- Transfemoral access is common for coronary interventions (CI).
- Vascular closure after procedures is crucial to prevent complications.
- Manual compression (MC) is a traditional method, but alternative devices exist.
Purpose of the Study:
- To compare the efficacy and safety of the Perclose Proglide (PP) suture-mediated vascular closure device against manual compression (MC).
- To evaluate complication rates following transfemoral access for coronary interventions.
Main Methods:
- A retrospective, observational, single-center study included 1743 patients undergoing transfemoral coronary interventions.
- Patients were divided into two groups: Perclose Proglide (PP) and manual compression (MC).
- Outcomes and complications were assessed at 24 hours and 30 days post-procedure.
Main Results:
- The Perclose Proglide group (1343 patients) showed significantly lower rates of minor bleeding and hematoma at 24 hours compared to the manual compression group (400 patients).
- At 30 days, the PP group also had significantly fewer instances of minor bleeding, hematoma, and pseudoaneurysm.
- Obesity and hypertension were identified as risk factors for increased minor bleeding at 24 hours.
Conclusions:
- The Perclose Proglide device is a safe and effective option for vascular closure after coronary interventions, demonstrating fewer complications than manual compression.
- The study highlights a low device failure rate of 2.38% for the Perclose Proglide.
- Obesity and hypertension are associated with a higher risk of minor bleeding, irrespective of the closure method used.
Objective:
To compare the outcome of suture mediated vascular closure device Perclose Proglide (PP) with manual compression (MC) following transfemoral access for coronary interventions (CI).
Methods:
It is a retrospective, observational, single centre study from January 2018 to September 2019. Consecutive patients undergoing interventions through transfemoral access were divided into PP and MC groups. Those with less than 3 months follow up were excluded. Two groups were compared for baseline characteristics and various complications at 24 h and at 30 days.
Results:
Out of 1743 patients studied, PP group included 1343 and MC group, 400 patients. Both groups were comparable in baseline characteristics, sheath size and use of antiplatelets and anticoagulation. PP group had significantly less minor bleeding (P = .01, CI 0.34-4.03) and hematoma (P = .0007, CI 0.95-5.10) at 24 h. At 30 days, minor bleeding (P < .0001, CI 0.97-4.25), hematoma (P = .0002, CI 1.05-4.93) and pseudo-aneurysm (P = .0095, CI 0.03-1.18) were also significantly less in PP group. Obesity (OR 3.5, CI 1.29-9.49) and hypertension (OR 2.41, CI 1.12-5.19) were associated with increased minor bleeding at 24 h. Device failure rate was 2.38%.
Conclusions:
PP device is safe, effective and is associated with fewer complications than MC in CI. Device failure rate is low. Obesity and hypertension are associated with increased minor bleeding in both groups.
