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Vascular Closure: the ABC’s

  • Interventional Cardiology (SR Bailey and T Helmy, Section Editors)
  • Published:
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Abstract

Purpose of Review

Vascular access and closure is a key part of endovascular procedures, and access site-related complications are an independent predictor of adverse procedural outcomes. The purpose of this review is to discuss the methods of vascular closure including manual compression, vascular closure devices (VCDs) for both arterial and venous arteriotomies, their mechanisms, and access site-related complications.

Recent Findings

Various VCDs have been approved over the last three decades. These devices have different mechanisms to achieve hemostasis and are generally categorized into active and passive approximators. Studies have largely found that they are non-inferior to manual compression.

Summary

Uncomplicated vascular closure is pertinent to avoid adverse procedure-related outcomes. The emergence of VCDs has reduced time to hemostasis, facilitating early ambulation and discharge and reducing hospitalization cost with comparable complication rate to manual compression. Nonetheless, they should be used in favorable vascular anatomy and are not intended to reduce complications.

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Authors and Affiliations

  1. Section of Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving St.Suite 4B-1, Washington, NWDC, 20010, USA

    Sukhdeep Bhogal & Ron Waksman

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  1. Sukhdeep Bhogal
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Contributions

Sukhdeep Bhogal conducted the literature search, performed data analysis, and drafted the manuscript. Ron Waksman critically revised the work.

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Correspondence to Ron Waksman.

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This manuscript is a review of the literature and therefore is exempted from ethical approval requirements.

Conflict of Interest

Ron Waksman reports serving on the advisory boards of Abbott Vascular, Boston Scientific, Medtronic, Philips IGT, and Pi-Cardia Ltd.; being a consultant for Abbott Vascular, Biotronik, Boston Scientific, Cordis, Medtronic, Philips IGT, Pi-Cardia Ltd., Swiss Interventional Systems/SIS Medical AG, Transmural Systems Inc., and Venous MedTech; receiving grant support from AstraZeneca, Biotronik, Boston Scientific, Chiesi, Medtronic, and Philips IGT; serving on the speakers bureau of AstraZeneca; and being an investor in MedAlliance and Transmural Systems Inc., outside the scope of the submitted work. Sukhdeep Bhogal has no competing interests to declare.

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Bhogal, S., Waksman, R. Vascular Closure: the ABC’s. Curr Cardiol Rep 24, 355–364 (2022). https://doi.org/10.1007/s11886-022-01654-z

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