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Related Experiment Video

Updated: Jul 10, 2025

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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A systematic algorithm for large-bore arterial access closure after TAVI: the TAVI-MultiCLOSE study.

Liesbeth Rosseel1,2, Nicholas J Montarello1, Philippe Nuyens1

  • 1The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|November 20, 2023
PubMed
Summary

The MultiCLOSE algorithm offers safe and effective vascular closure after transfemoral transcatheter aortic valve implantation (TF-TAVI). This approach significantly reduces major vascular complications, improving patient outcomes.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Transcatheter aortic valve implantation (TAVI) is a standard procedure.
  • Access site bleeding and vascular complications remain significant concerns, impacting patient morbidity and mortality.

Purpose of the Study:

  • To evaluate the safety and efficacy of the novel MultiCLOSE vascular closure algorithm.
  • To assess its performance in percutaneous large-bore arterial access closure following transfemoral TAVI (TF-TAVI).

Main Methods:

  • Prospective, multicentre, observational study of TF-TAVI cases using the MultiCLOSE algorithm.
  • A stepwise approach involving initial preclosure with suture-based vascular closure devices (VCDs), followed by sheath reinsertion for assessment and tailored final closure.
  • Utilized either additional suture- or plug-based VCDs, or no further intervention.

Main Results:

  • Complete arterial hemostasis achieved in 98% of 630 patients.
  • Vascular closure device (VCD) failure occurred in 2% of patients, managed with balloon inflation, covered stent, or surgical repair.
  • Low rates of minor (2.2%) and major (0.6%) vascular complications, with only 0.2% new minor complications at 30 days. In-hospital and 30-day all-cause mortality were 0.2% and 1.0%, respectively.

Conclusions:

  • The MultiCLOSE algorithm provides an easy, safe, and effective method for vascular closure post-TF-TAVI.
  • This algorithm results in durable vascular closure with a major complication rate below 1%.