Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients
Objective: Vascular closure devices (VCDs), such as the Angio-Seal, a three-component hemostatic plug, have greatly facilitated the routine clinical practice in the catheterization laboratory. The manufacturer recommends a local angiogram before Angio-Seal deployment. However, from the outset, we em...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-07-01
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| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483215009025 |
| _version_ | 1819095108847403008 |
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| author | Antonis S. Manolis Georgios Georgiopoulos Dimitris Stalikas Spyridon Koulouris |
| author_facet | Antonis S. Manolis Georgios Georgiopoulos Dimitris Stalikas Spyridon Koulouris |
| author_sort | Antonis S. Manolis |
| collection | DOAJ |
| description | Objective: Vascular closure devices (VCDs), such as the Angio-Seal, a three-component hemostatic plug, have greatly facilitated the routine clinical practice in the catheterization laboratory. The manufacturer recommends a local angiogram before Angio-Seal deployment. However, from the outset, we employed a simplified routine of deploying this VCD, i.e. without use of local angiography.
Methods: The Angio-Seal was employed without a preceding femoral arteriogram over 8 years in 2074 consecutive patients, 72% presenting with acute coronary syndromes and subjected to coronary angiography (n = 1032) or PCI n = 1042) via a transfemoral approach with use of heparin and dual antiplatelet therapy.
Results: Deployment of the VCD was successful in 99.4%. Complete hemostasis was obtained in 98% of cases. In 14 patients, Angio-Seal deployment failed. Mean time for placement of Angio-Seal was <1 min, to-hemostasis 1 min, and to-mobilization 3 h. Only 3 (0.15%) patients had a major complication with vessel occlusion that required emergent vascular surgery with a successful outcome. Two patients developed a local pseudoaneurysm treated with ultrasonography-guided compression. Six small and 4 large inguinal hematomas (one requiring blood transfusion) and 5 cases of retroperitoneal bleeding (one requiring blood transfusion) were recorded.
Conclusion: Deployment of Angio-Seal without use of local angiography was efficacious and safe, characterized by a high success rate of deployment and hemostasis with few correctable complications in a large patient cohort undergoing transfemoral catheterization for PCI and non-PCI procedures under anticoagulation and antiplatelet drug therapy. VCD reduced the time-to-hemostasis and time-to-mobilization and minimized the incidence of complications. |
| first_indexed | 2024-12-21T23:38:04Z |
| format | Article |
| id | doaj.art-23e2e5916c484c5fac83f1450f9fde1e |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-21T23:38:04Z |
| publishDate | 2016-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-23e2e5916c484c5fac83f1450f9fde1e2022-12-21T18:46:19ZengElsevierIndian Heart Journal0019-48322016-07-0168452953810.1016/j.ihj.2015.11.036Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patientsAntonis S. ManolisGeorgios GeorgiopoulosDimitris StalikasSpyridon KoulourisObjective: Vascular closure devices (VCDs), such as the Angio-Seal, a three-component hemostatic plug, have greatly facilitated the routine clinical practice in the catheterization laboratory. The manufacturer recommends a local angiogram before Angio-Seal deployment. However, from the outset, we employed a simplified routine of deploying this VCD, i.e. without use of local angiography. Methods: The Angio-Seal was employed without a preceding femoral arteriogram over 8 years in 2074 consecutive patients, 72% presenting with acute coronary syndromes and subjected to coronary angiography (n = 1032) or PCI n = 1042) via a transfemoral approach with use of heparin and dual antiplatelet therapy. Results: Deployment of the VCD was successful in 99.4%. Complete hemostasis was obtained in 98% of cases. In 14 patients, Angio-Seal deployment failed. Mean time for placement of Angio-Seal was <1 min, to-hemostasis 1 min, and to-mobilization 3 h. Only 3 (0.15%) patients had a major complication with vessel occlusion that required emergent vascular surgery with a successful outcome. Two patients developed a local pseudoaneurysm treated with ultrasonography-guided compression. Six small and 4 large inguinal hematomas (one requiring blood transfusion) and 5 cases of retroperitoneal bleeding (one requiring blood transfusion) were recorded. Conclusion: Deployment of Angio-Seal without use of local angiography was efficacious and safe, characterized by a high success rate of deployment and hemostasis with few correctable complications in a large patient cohort undergoing transfemoral catheterization for PCI and non-PCI procedures under anticoagulation and antiplatelet drug therapy. VCD reduced the time-to-hemostasis and time-to-mobilization and minimized the incidence of complications.http://www.sciencedirect.com/science/article/pii/S0019483215009025Cardiac catheterizationTransfemoral techniqueVascular closure deviceAngio-SealPercutaneous coronary intervention |
| spellingShingle | Antonis S. Manolis Georgios Georgiopoulos Dimitris Stalikas Spyridon Koulouris Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients Indian Heart Journal Cardiac catheterization Transfemoral technique Vascular closure device Angio-Seal Percutaneous coronary intervention |
| title | Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients |
| title_full | Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients |
| title_fullStr | Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients |
| title_full_unstemmed | Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients |
| title_short | Simplified swift and safe vascular closure device deployment without a local arteriogram: Single center experience in 2074 consecutive patients |
| title_sort | simplified swift and safe vascular closure device deployment without a local arteriogram single center experience in 2074 consecutive patients |
| topic | Cardiac catheterization Transfemoral technique Vascular closure device Angio-Seal Percutaneous coronary intervention |
| url | http://www.sciencedirect.com/science/article/pii/S0019483215009025 |
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