Closure of mid‐bore venotomies with VASCADE VCD after right and left heart catheterization

Abstract

Objective This single‐center, retrospective analysis investigated the clinical outcomes of a novel vascular closure device (VASCADE, Cardiva Medical, Santa Clara, CA) for closure of 7F femoral venotomies. Background The VASCADE closure device has been widely used to close arteriotomy sites following femoral procedures; however, little data have been published regarding the device's utility in closure of venotomy sites after procedures such as right‐heart catheterization. Methods This was a retrospective analysis of outcomes in 102 consecutive patients who underwent venous closure using the VASCADE device following diagnostic right and left‐heart catheterization between April 2016 to May 2018. Patients’ age, gender, valvular disease status, comorbidities, and periprocedural use of antiplatelet/anticoagulant therapy were analyzed. Results Closure was successful in 99% (101/102) of patients with respect to achieving the primary outcome of rapid hemostasis in ≤3 min. There was one device failure requiring manual compression, with no further complications. There were no other related adverse events or complications through 30 days of follow‐up. Conclusions The VASCADE device achieved venous hemostasis in nearly all our patients. We believe devices for venous closure can aid in improving patient experience, safety, and efficiency during these procedures.

Femoral venous closure: A single-centre retrospective analysis in real world all comers with MynxGrip® vascular closure device

“…The use of some VCDs for femoral venous closure has been reported, mainly from small retrospective studies (summarised in table 1) [6][7][8][9][10][11][12][13][14][15]. Coto, et al, (2002) studied the use of AngioSeal (St Jude) to close the common femoral vein in 110 patients undergoing cardiac catheterisation or intervention requiring venous access, demonstrating 100% successful deployment and haemostasis without complication [6].…”

“…Subsequent other studies have evaluated an alternative 'pre-closure' technique in which the 6F Perclose device is deployed at the start of the procedure followed by insertion of larger venous sheaths of up to 24 Fr, with tightening of the sutures delayed until the sheath is removed from the vessel, demonstrating similarly higher success rates and only minimal minor bleeding complications [9][10][11][12][13]. Two separate retrospective studies involving use of VASCADE device (Cardiva Medical) in 21 and 102 patients respectively reported 93.8% and 99% haemostasis with a few minor hematomas, one case of deep vein thrombosis and one device failure despite a signi icant proportion of patients receiving some periprocedural antiplatelet or anticoagulation therapy [14,15].…”