Preclose Versus Postclose Using Suture-Mediated Vascular Closure System for Catheter Ablation With Femoral Vein...

Area of Science:

• Cardiovascular Interventions
• Vascular Surgery
• Medical Device Technology

Background:

• Suture-mediated vascular closure systems are used for femoral vein access.
• Efficacy and safety differences between preclose and postclose techniques require further investigation.

Purpose of the Study:

• To compare the efficacy and safety of preclose versus postclose suture techniques for femoral vein access.
• Evaluate rebleeding rates, time to hemostasis, and complication incidence.

Main Methods:

• Randomized trial of 282 patients undergoing elective catheter ablation via femoral vein access (8-13F sheath).
• Patients randomized to single-suture preclose or postclose technique using ProGlide/ProStyle.
• Vascular complications assessed by duplex ultrasound at 1 and 90 days.

Main Results:

• Preclose group showed significantly lower rebleeding rates (3.5% vs 10.6%, P=0.03) and faster hemostasis (254.0s vs 299.8s, P=0.02).
• Major complication rates were similar (0.7% in both groups, P=1.00).
• Minor complication rates were also comparable between preclose (13.2%) and postclose (15.4%) groups (P=0.73).

Conclusions:

• The preclose technique demonstrates superior hemostasis and reduced rebleeding compared to the postclose technique for femoral vein access.
• The preclose technique does not compromise safety, showing similar major and minor complication rates.
• Preclose suture-mediated closure is an effective and safe alternative for femoral vein access.