Use of vascular closure device is safe and effective in electrophysiological procedures

Maraj, Ilir; Budzikowski, Adam S.; Ali, Waleed; Mitre, Crisitina A.; Kassotis, John

doi:10.1007/s10840-015-0005-5

Cited by 10 publications

(12 citation statements)

References 8 publications

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“…A suture-mediated Perclose device has been successfully used to achieve rapid hemostasis in the presence of anticoagulation in adults undergoing congenital cardiac intervention [11] . Femoral venous hemostasis has been achieved with a collagen vascular closure device (Angioseal) in patients that required peri-procedural anticoagulation and multiple vascular access sites [12] . However, these devices are resource-intense, are associated with steep learning curves, and may be associated with patient discomfort during deployment.…”

Section: Discussionmentioning

confidence: 99%

Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation

Lakshmanadoss

Wong

Kutinsky

et al. 2017

Indian Pacing and Electrophysiology Journal

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IntroductionLimited data exists for types of venous closure and its associated complications in patients after atrial fibrillation (AF) catheter ablation. We evaluated the subcutaneous figure-of-eight closure (FO8) for achieving venous hemostasis after AF catheter ablation compared to manual pressure.Methods284 consecutive patients that underwent AF catheter ablation by two operators were included. All patients received continuous therapeutic warfarin or interrupted novel oral anticoagulants (NOAC) and heparin (ACT300-400 s) without reversal. Patients were divided into two groups: 1) sheaths were left in place and pulled once ACT < 180 s, with hemostasis being achieved with manual pressure (MP); and 2) a subcutaneous FO8 suture closed the venous access site immediately after the ablation on each groin site and sheaths were removed immediately after the ablation despite full anticoagulation with heparin and warfarin or interrupted NOAC. Sutures were removed after four hours, and the patients laid flat for an additional two hours.ResultsThe MP group (n = 105) was similar to the FO8 group (n = 179). Time in bed was 573 ± 80 min for MP group vs. 373 ± 49 min for FO8 group (p < 0.0001). Eleven hematomas were seen in the MP group compared to seven in the FO8 group (P = 0.041).ConclusionsIn fully anticoagulated patients undergoing AF catheter ablation, excellent hemostasis was achieved with figure-of-eight sutures, with no major vascular complications, a lower hematoma rate, and a significantly shorter flat-time-in-bed compared to manual pressure.

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Section: Discussionmentioning

confidence: 99%

Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation

Lakshmanadoss

Wong

Kutinsky

et al. 2017

Indian Pacing and Electrophysiology Journal

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“…thromboembolism. [17][18][19][20][21][22] Coto et al studied the use of an 8 Fr AngioSeal device for femoral venous closure and venous hemostasis was successfully achieved; however, 8% of patients had bleeding due to ipsilateral arterial access. 23 A study by Maraj et al on a small number of patients found the use of AngioSeal to be effective in closing multiple venous access on the same vein without reported device dislodgements.…”

Section: Discussionmentioning

confidence: 99%

“…23 A study by Maraj et al on a small number of patients found the use of AngioSeal to be effective in closing multiple venous access on the same vein without reported device dislodgements. 19 attributed to inadequate knot tie or suture break. 4,6 A modified F8 suture, where a three-way stopcock is utilized instead of knots, was evaluated by Yorgun et al In comparison to the standard F8 suture, the use of the modified F8 resulted in a shorter time to hemostasis with no documented minor or major access site complication.…”

Section: Discussionmentioning

confidence: 99%

A comparison of figure‐of‐8‐suture versus manual compression for venous access closure after cardiac procedures: An updated meta‐analysis

Mujer

Al-abcha

Flores³

et al. 2020

Pacing Clinical Electrophis

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Background: Manual compression (MC) is the current standard to achieve postprocedural hemostasis in patients who need venous vascular access closure after cardiovascular procedures. Figure-of-8 (F8) suture for venous access closure has been reported to be a safe and efficacious alternative to MC. Methods: A systematic search was done using PubMed, Google Scholar, EMBASE, SCOPUS, and ClinicalTrials.gov without language restriction up until April 15, 2020 for studies comparing F8 suture versus MC. Risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI) were calculated using a random effects model.

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“…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].…”

Section: Introductionmentioning

confidence: 99%

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

Harvard¹,

Thirunavukarasu²,

Hayat³

et al. 2020

J Cardiol Cardiovasc Med

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Background: Vascular closure devices (VCD) are routinely used to achieve haemostasis following percutaneous arterial procedures. The extravascular polyethylene-glycol based MynxGrip ® device (Cardinal Health) received FDA approval for use in the closure of femoral veins, but so far limited data is available on its use, especially with concomitant use of anticoagulants. Method: This is a retrospective analysis of data from a single-centre on the eff ectiveness and complication rates following the use of the MynxGrip ® device for femoral venous closure in patients undergoing diagnostic/interventional (temporary pacing during balloon aortic valvuloplasty, or electrophysiology) procedures utilising 5-7F sheaths. Results: 85 patients (mean age 74 years) underwent femoral venous closure with the MynxGrip ® device. 51.8% were male. The rate of concomitant anticoagulant or antiplatelet use was 52.9%. Device deployment was 100% successful with full haemostasis in all cases. There were no major vascular complications (bleeding, thrombosis, or infections). There was one case of a minor small venous hematoma which did not require treatment. The mean length of stay was less than 1 day (67.1% patients discharged the same day) and overnight stay only indicated by interventional procedure. Conclusion: This data supports safety and effi cacy of the MynxGrip ® device for femoral venous closure with same-day discharge, even with concomitant aggressive antiplatelet and anticoagulant use. It has the potential for use in other large bore venous access sites.

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Use of vascular closure device is safe and effective in electrophysiological procedures

Abstract: We provide evidence that a collagen plug-based VCD designed for arterial closure can be safely and effectively used to close multiple venous accesses even in the same vein. This can be accomplished with a venotomy size up to 2 Fr larger than the size of the closure device.

Cited by 10 publications

References 8 publications

Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation

Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation

A comparison of figure‐of‐8‐suture versus manual compression for venous access closure after cardiac procedures: An updated meta‐analysis

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

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