Safety and efficacy of arterial closure devices in an office-based angiosuite

This study evaluates the safety and efficacy of arterial closure devices (ACDs) used in arterial procedures between 2018 and 2023, comparing patient outcomes with data from 2012 to 2013. The primary objective was to assess changes in patient outcomes in a larger patient dataset after modifications in ACD use in clinical practice.

Data were retrospectively reviewed, covering femoral, radial, and pedal access cases performed by 15 providers. The study analyzed complications and success rates of various ACDs, including the Angio-Seal VIP, Mynx Control, Perclose ProGlide, Celt ACD, Vascade MVP, and StarClose SE. The study observed a transition toward the preferential use of the Angio-Seal for diseased arteries, the Mynx for smaller arteries, and the Perclose only for nondiseased arteries. We used closure devices on all the femoral access cases and manual compression on all radial and pedal access cases.

Results indicate a significant improvement in patient outcomes with the revised ACD protocols. In response to the previous study's findings, the usage rate of the Angio-Seal increased from 13% to 55%, the Mynx and Perclose decreased, and both practices have stopped using the Starclose and Exoseal altogether; the use rate for these two devices is now 0%. Manual compression usage rates have increased from 4.6% to 17.0%. Complication rates for the Angio-Seal, Mynx, and Perclose were decreased significantly in this larger patient cohort after changes in clinical practice.

Overall, complication rates, transfers, and deaths remained low. The clinical recommendations made in the previous study were effective, particularly the increase in Angio-Seal use in most patient cases. Further studies are recommended to optimize ACD use in an office-based laboratory.