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Vascular closure devices in electrophysiology procedures: Systematic review and meta-analysis
Leonardo M Knijnik1, Birju R Rao1, Soroosh Kiani2
1Emory University, Atlanta, Georgia.
Background:
Vascular closure devices (VCDs) have been shown to reduce the time to hemostasis in single-point arterial access sites, but their benefit in electrophysiology (EP) procedures requiring multipoint venous access remains uncertain.
Objective:
This study aimed to perform a systematic review and meta-analysis evaluating the efficacy and safety of VCDs compared with manual compression or figure-of-8 suture for venous hemostasis after EP procedures.
Methods:
A systematic search of PubMed, Scopus, and Google Scholar was conducted in June 2025 to identify randomized controlled trials comparing VCDs with manual or figure-of-8 closure in EP procedures.
Results:
6 randomized controlled trials including 848 patients (460 treated with VCDs) were analyzed. VCDs significantly reduced hematoma formation (3.4% vs 7.7%; odds ratio, 0.51; 95% confidence interval, 0.25-0.92; P = .03) and a composite outcome of all vascular complications (10.4% vs 17.2%; odds ratio, 0.70; 95% confidence interval, 0.50-0.98; P = .04). Times to hemostasis, ambulation, and disposition were significantly shorter in the VCD group by 5.5, 129, and 84 minutes, respectively.
Conclusion:
VCDs modestly reduce vascular complications and significantly shorten recovery time after EP procedures.
