Related Experiment Video
Updated: Jan 11, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Single perclose escalation technique: A novel approach for vascular closure following Transcatheter Aortic Valve
Andrea Virginia Monastyrski1, Vicenç Serra García2, Ricardo Palma Carbajal1
1Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
Background:
Suture-based vascular closure devices (VCDs) are commonly used for large-bore arteriotomy closure, but real-world comparisons of different closure strategies remain limited. We aimed to evaluate the safety and efficacy of the Single Perclose ProGlide Escalation Technique (SPET) and compare it with Double Perclose ProGlide Technique (DPT).
Methods:
This is an observational, single-center, retrospective study of all consecutive patients who underwent transfemoral transcatheter aortic valve replacement (TAVR) between January 2017 and January 2023. The SPET group used a single initial Perclose ProGlide, followed by post-TAVR angiography to assess the need for additional VCDs. After propensity score matching, we compared SPET with the standard DPT. The primary endpoint was a composite of major vascular complications or bleeding ≥2 per VARC 3 criteria, occurring either in-hospital or within 30 days post-procedure. Minor vascular complications, and the number of VCDs used was assessed as secondary endpoints.
Results:
From an initial cohort of 671, 446 patients were selected through propensity score matching, resulting in two well-balanced groups of 223 each (median age 81 ± 7, 53.6 % female). No significant differences in the primary endpoint were observed (4 % vs. 5.8 %, p = 0.38). The SPET group had significantly fewer minor vascular complications (0.9 % vs. 4.9 %, p = 0.011) and reduced use of VCDs (1.96 vs. 2.09, p = 0.006), with up to 22 % of patients not requiring any additional devices.
Conclusions:
The SPET technique appears to be safe and effective after transfemoral TAVR, reducing minor vascular complications without increasing the risk of major vascular complications or bleeding compared to DPT.
