Double ProGlide preclose technique for vascular access closure after leadless pacemaker implantation

Area of Science:

• Cardiology
• Medical Devices
• Vascular Access

Background:

• Leadless pacemakers offer advantages but require reliable vascular access hemostasis.
• Traditional manual hemostasis can lead to prolonged recovery and complications like venous thrombosis.
• Vascular closure devices (VCDs) are increasingly used to manage access sites.

Purpose of the Study:

• To evaluate the feasibility of using a double Perclose ProGlide preclosure technique for hemostasis after Micra leadless pacemaker implantation.
• To assess the safety and efficacy of this VCD approach in facilitating early patient mobilization.

Main Methods:

• A retrospective review of 36 patients who underwent leadless pacemaker implantation with double Perclose ProGlide preclosure.
• Data collected included complications, time to ambulation, and incidence of venous thromboembolism.
• Two ProGlide devices were deployed following ultrasound-guided wire access.

Main Results:

• No major complications, prolonged flat time, transfusions, or venous thromboembolism occurred within 30 days.
• One patient experienced minor rebleeding, requiring brief manual pressure and a 2-hour extension of flat time.
• The technique facilitated early ambulation, with patients instructed to lay flat for only 2-4 hours.

Conclusions:

• The double Perclose ProGlide preclosure technique is a safe and feasible method for achieving hemostasis at the access site.
• This approach effectively facilitates early ambulation after leadless pacemaker procedures.
• The VCD technique may reduce complications and improve patient recovery compared to manual hemostasis.