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Hepatic and splenic venous access tract closure using the VASCADE vascular closure system following percutaneous
Lindsay F Eilers1, Manish Bansal1, Asra Khan1
1Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Insights
The VASCADE Vascular Closure System safely closed hepatic and splenic venous access sites in pediatric cardiac catheterization procedures. This novel approach shows promise in reducing bleeding complications in young patients.
Area of Science:
- Interventional Cardiology
- Vascular Access Management
- Pediatric Cardiac Procedures
Background:
- Hepatic and splenic venous access are specialized techniques for cardiac catheterization.
- Bleeding is a common complication of these venous access methods.
- The VASCADE Vascular Closure System is approved for femoral access closure in adults.
Purpose of the Study:
- To evaluate the safety and efficacy of the VASCADE Vascular Closure System for hepatic or splenic venous access sites.
- To assess the potential of VASCADE in reducing post-procedural bleeding complications in pediatric patients undergoing cardiac catheterization.
Main Methods:
- Single-center retrospective review of patients undergoing percutaneous hepatic or splenic venous access.
- Tract closure was performed using the VASCADE Vascular Closure System.
- Data collected from March 2022 to October 2023.
Main Results:
- Ten pediatric patients (16 procedures) underwent closure with VASCADE.
- Successful closure was achieved in all patients (15 hepatic, 2 splenic access sites).
- No major adverse events related to VASCADE closure were reported.
Conclusions:
- VASCADE is a safe option for closing transhepatic and trans-splenic venous access sites in pediatric cardiac catheterization.
- The device may reduce the risk of bleeding complications.
- Further studies in larger pediatric cohorts are warranted to confirm safety and efficacy.
Background:
Hepatic and splenic venous access are specialised techniques used to perform diagnostic and interventional procedures in the cardiac catheterisation laboratory. Bleeding events are the most commonly reported complication following hepatic or splenic venous access. The VASCADE Vascular Closure System (Cardiva Medical Inc. Santa Barbara, CA) is an approved device for closure of femoral vascular access tracts in patients ≥18 years of age. We report our experience using VASCADE to close the hepatic or splenic venous access site in the cardiac catheterisation laboratory.
Methods:
This is a single centre retrospective review of all patients who had percutaneous hepatic or splenic venous access obtained in the cardiac catheterisation laboratory from March 1, 2022 through October 30, 2023 and underwent tract closure with VASCADE.
Results:
Ten patients (six male) underwent 16 procedures (median age and weight 3.5 years and 12.5 kg) with 15 hepatic and two splenic veins accessed. Successful closure of the access tracts with VASCADE was performed in all patients. There were no major adverse events related to closure of the access sites with VASCADE.
Conclusion:
VASCADE can be used following transhepatic and trans-splenic venous access in the cardiac catheterisation laboratory to safely close the access tract and potentially reduce the risk of post-procedural bleeding complications. Further evaluation in a larger cohort of patients is needed to ensure VASCADE is safe for use and provides adequate haemostasis following hepatic or splenic venous access, particularly in children.
