A Prospective Randomized Trial Comparing the Safety and Efficacy of Three Commercially Available Closure Devices (Angioseal, Vasoseal and Duett)

Abstract

The three closure devices had high rates of successful deployment and were relatively safe. The Angioseal resulted in earlier ambulation after angiography. Utilization of closure devices after abciximab administration possibly increased the complications.

Access site management with vascular closure devices for percutaneous transarterial procedures

“…In one single institution randomized study involving 705 patients randomized to three ACD (Angio-Seal, VasoSeal, and Duett) in the setting of diagnostic and percutaneous coronary intervention (PCI), which requires a larger sheath, all three devices had a high rate of technical success with surgical intervention rate of 1%. 33 Angio-Seal provided earlier time to ambulation compared with the other two devices. All three devices were considered safe; however, the vasoseal device had a slightly higher rate of complication compared with the other two in the PCI group.…”

“…All three devices were considered safe; however, the vasoseal device had a slightly higher rate of complication compared with the other two in the PCI group. 33 In another larger series evaluating ACD use in the setting of PCI and anticoagulation in more than 4500 patients, ACD had a similar or lower complication rate than MC. 34 The two devices used were Angio-Seal and Perclose.…”

“…Numerous clinical series have reported high technical success rates ranging from 90% to 100%. 4,17,18,33,38,47 In patients who received systemic anticoagulation, this device remained efficacious in achieving hemostasis following percutaneous interventions. 17,47,48 Several comparative studies between the VasoSeal device and manual compression demonstrated no differences in the rate of femoral artery pseudoaneurysm or hematoma formation.…”

Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia

“…The use of a PLT count of 60x10 9 /l as a cut-off for TACE is unnecessarily restrictive when there are newer options for access site management with closure devices, improved performance of lower profile catheters and newer access techniques, such as radial artery catheterization. Artery compressors have the advantages of short hemostasis time and short immobilization time of the punctured limb (27). A radial arterial access site has the advantages of minimal invasiveness, is easy to compress and achieve hemostasis, with less local bleeding and fewer vascular complications (28).…”

Relationship Between Femoral Vascular Closure Devices and Short-Term Mortality From 271 845 Percutaneous Coronary Intervention Procedures Performed in the United Kingdom Between 2006 and 2011

“…[17][18][19][20] The main advantages of VCDs are greater patient comfort and improved cost-effectiveness because of reduced puncture site hemostasis time, bed rest, time to ambulation, and hospital stay compared with manual compression. [17][18][19][20][21][22] Although evidence has accrued that VCDs (compared with manual compression) may be of greater value in higher-risk subjects-such as those receiving anticoagulant agents-in terms of reducing bleeding complications, [23][24][25][26][27][28][29] with 1 population-based study (US CathPCI registry, n=1 819 611) 29 associating the most frequently used VCDs with a substantial reduction in bleeding and vascular complications, this has proven to be controversial, particularly because VCDs in themselves have been associated with life-threatening complications. 21,[30][31][32][33][34][35][36] Consequently, the 2010 American Heart Association guidelines give a class IIa recommendation for VCD (reasonable to perform the procedure) to achieve faster hemostasis and improve patient comfort and a class III recommendation (procedure should not be performed because it is not helpful and may be harmful) when used with the intent to reduce vascular complications.…”