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Ultrasound Guided Versus Conventional Closure Device Deployment Following Transfemoral Endovascular Procedures: A
I Kalaja1, R R Smeets2, M Wegner3
1Department for Cardiology III - Angiology, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
Summary
Ultrasound guidance for vascular closure devices significantly reduces femoral access site complications in endovascular procedures. This method enhances patient safety during percutaneous arterial access compared to conventional techniques.
Area of Science:
- Cardiovascular Interventions
- Medical Imaging
- Vascular Surgery
Background:
- Femoral access site complications negatively impact patient outcomes after endovascular procedures.
- While ultrasound guidance is standard for arterial puncture, its use in vascular closure device deployment is limited.
Purpose of the Study:
- To systematically evaluate the safety and efficacy of ultrasound-guided vascular closure device deployment.
- To compare outcomes of ultrasound-guided closure versus conventional closure in transfemoral arterial interventions.
Main Methods:
- A systematic literature search was performed using Web of Science, PubMed, and Cochrane Library.
- A meta-analysis included studies comparing ultrasound-guided closure with conventional closure in transfemoral arterial interventions.
- Included patients received either ultrasound-guided closure (2,738) or conventional closure (1,175).
Main Results:
- Ultrasound-guided closure was associated with significantly reduced access site complications compared to conventional closure (OR 0.49; 95% CI 0.37-0.65; p < .001).
- This benefit was observed for both small and large sheath sizes.
- The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) analysis indicated a low certainty of evidence.
Conclusions:
- Ultrasound-guided femoral artery closure appears to lower the rate of access site complications.
- Implementing ultrasound guidance for vascular closure devices may improve procedural and patient safety in percutaneous arterial access.
