DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170516

Percutaneous vascular closure device of the femoral access site after coronary interventions for acute coronary syndrome -immediate and short term follow-up

Ashraf Safiya Manzil, Sidharaj Vala, Sidharaj Vala

Abstract


Background: Around 7 million patients undergo percutaneous interventional vascular procedures worldwide annually and this number is expected to escalate further in coming years. The aim of this study was to analyse immediate and short term follow up of patients with acute coronary syndrome (ACS) who had undergone percutaneous coronary intervention (PCI) through femoral route and closure with vascular closure device.

Methods: This was non randomised, single centre study and was conducted in a tertiary care institution between January 2013 to June 2014 with 62 ACS patients undergoing femoral access invasive cardiac interventional procedure. Perclose A-T system was used in all patients as closure device. Patients were followed up to 15 days of clinical evaluation.

Results: Of 62 ACS patients, 40 (64.5%) were with non-ST elevation myocardial infarction and 22 (35.5%) patients had history of unstable angina. The perclose device achieved closure within 5 to 10 minutes and all patients were kept in hospital stay for 2 to 3 days. There was one major complication of continuous bleeding, one incidence of small pseudo aneurysm, and two incidences of small hematomas with need of blood transfusion.

Conclusions: This study demonstrates the ability of arterial closure device to safely and effectively achieve arterial closure in patients undergoing percutaneous intervention for ACS.


Keywords


Acute coronary syndrome, Hemostasis, Percutaneous coronary intervention, Vascular closure devices

Full Text:

PDF

References


Patel MR, Jneid H, Derdeyn CP, Klein LW, Levine GN, Lookstein RA, et al. Arteriotomy Closure Devices for Cardiovascular Procedures A Scientific Statement From the American Heart Association. Circulation. 2010;122(18):1882-93.

Meyerson SL, Feldman T, Desai TR, Leef J, Schwartz LB, Mckinsey JF. Anglographic Access Site Complications in the Era of Arterial Closure Devices. Vascular and endovascular surgery. 2002;36(2):137-44.

Dauerman HL, Applegate RJ, Cohen DJ. Vascular closure devices: the second decade. J Amer Colle Cardio. 2007;50(17):1617-26.

Behan M, Large J, Patel N, Lloyd G, Sulke A. A randomised controlled trial comparing the routine use of an Angio‐Seal STS device strategy with conventional femoral haemostasis methods in a district general hospital. Inter J clin pract. 2007;61(3):367-72.

Alshehri AM, Elsharawy M. Comparison of Angioseal and Manual Compression in Patients Undergoing Transfemoral Coronary and Peripheral Vascular Interventional Procedures. Inter J Ang. 2015;24(02):133-6.

Schwartz BG, Burstein S, Economides C, Kloner RA, Shavelle DM, Mayeda GS. Review of vascular closure devices. J Inv Cardio. 2010;22(12):599-607.

Rashid MN, Bailey SR. Percutaneous femoral access and vascular closure devices. Science Innovation Synergy Yearbook 2007. 2008.

Tordini A, Polkampally PR, Jovin IS. Vascular closure devices in percutaneous coronary and peripheral interventions: rationale and results. Interv Cardio. 2012;4(5):569-76.

Vaitkus PT. A meta-analysis of percutaneous vascular closure devices after diagnostic catheterization and percutaneous coronary intervention. Journal Inv Cardio. 2004;16(5):243-6.

Dangas G, Mehran R, Kokolis S, Feldman D, Satler LF, Pichard AD, et al. Vascular complications after percutaneous coronary interventions following hemostasis with manual compression versus arteriotomy closure devices. J Amer Colle Cardio. 2001;38(3):638-41.

Applegate RJ, Sacrinty MT, Kutcher MA, Baki TT, Gandhi SK, Santos RM, et al. Propensity score analysis of vascular complications after diagnostic cardiac catheterization and percutaneous coronary intervention using thrombin hemostatic patch-facilitated manual compression. J Inv Cardio. 2007;19(4):164-70.

Hamon M, Rasmussen LH, Manoukian SV, Cequier A, Lincoff MA, Rupprecht H-J, et al. Choice of arterial access site and outcomes in patients with acute coronary syndromes managed with an early invasive strategy: the ACUITY trial. EuroIntervention. 2009;5(1):115-20.

Vorobcsuk A, Kónyi A, Aradi D, Horváth IG, Ungi I, Louvard Y, et al. Transradial versus transfemoral percutaneous coronary intervention in acute myocardial infarction: systematic overview and meta-analysis. Amer heart J. 2009;158(5):814-21.

Torsello G, Tessarek J, Kasprzak B, Klenk E. Treatment of aortic aneurysm with a complete percutaneous technique. Deutsche medizinische Wochenschrift. 2002;127(27):1453-7.

Applegate RJ, Grabarczyk MA, Little WC, Craven T, Walkup M, Kahl FR, et al. Vascular closure devices in patients treated with anticoagulation and IIb/IIIa receptor inhibitors during percutaneous revascularization. J Amer Colle Cardio. 2002;40(1):78-83.

Gerckens U, Cattelaens N, Lampe E-G, Grube E. Management of arterial puncture site after catheterization procedures: evaluating a suture-mediated closure device. Amer J Cardio. 1999;83(12):1658-63.

Baim DS, Knopf WD, Hinohara T, Schwarten DE, Schatz RA, Pinkerton CA, et al. Suture-mediated closure of the femoral access site after cardiac catheterization: results of the suture to ambulate and discharge (STAND I and STAND II) trials. Amer J Cardio. 2000;85(7):864-9.

Resnic FS, Blake GJ, Ohno-Machado L, Selwyn AP, Popma JJ, Rogers C. Vascular closure devices and the risk of vascular complications after percutaneous coronary intervention in patients receiving glycoprotein IIb-IIIa inhibitors. Amer J Cardio. 2001;88(5):493-6.

Koreny M, Riedmüller E, Nikfardjam M, Siostrzonek P, Müllner M. Arterial puncture closing devices compared with standard manual compression after cardiac catheterization: systematic review and meta-analysis. Jama. 2004;291(3):350-7.

Biancari F, D'Andrea V, Di Marco C, Savino G, Tiozzo V, Catania A. Meta-analysis of randomized trials on the efficacy of vascular closure devices after diagnostic angiography and angioplasty. Amer J Cardio. 2010;159(4):518-31.

Chambers CE, Eisenhauer MD, McNicol LB, Block PC, Phillips WJ, Dehmer GJ, et al. Infection control guidelines for the cardiac catheterization laboratory: society guidelines revisited. Catheterization and Cardiovascular Interventions. 2006;67(1):78-86.