Vascular Access Closure Devices

Abstract

In 2002, an estimated six million interventional cardiology and endovascular procedures were performed in the USA, and that number exceeded 10.5 million in 2009. In most of these procedures, the common femoral artery is used as the cardiac access site. For each of these cases, vascular access management is a critical aspect to determining a successful outcome without complications. For many decades, manual compression has been the “gold standard” for postprocedure vascular access management. With the development of endovascular procedures, larger sheaths and more intense anticoagulation measures are now routinely employed. These factors place greater demands on the safe performance of vascular access. In addition, many patients are likely to undergo repeated angiographic procedures over time, most frequently using the femoral artery as the vascular entry point. Site selection, puncture and closure must be optimized to avoid access site complications, primarily related to bleeding. Vascular Closure Devices (VCDs) were designed to decrease time to achieve hemostasis, as well as access site bleeding, thus permitting shorter time to patient ambulation, and increased patient comfort compared with manual compression.