Vascular Closure Devices

Abstract

Worldwide, between 7.5 and 8 million catheter-based vascular procedures are performed a year. Only around 20–25% of these procedures utilize a vascular closure device (VCD) for access site hemostasis. The use of larger sheaths and the widespread use of peri-procedural anticoagulation have increased the risk of bleeding complications, resulting in the need for better methods of hemostasis. Complication rates related to hemostasis for diagnostic angiograms range from 0 to 1.1%, and increase to 1.3–3.4% for therapeutic procedures. While the outcomes of VCD studies have shown increased patient satisfaction, early ambulation and decreased hospital resource utilization, compared with manual compression, there is limited evidence that hemorrhage and other puncture site complications are reduced by VCDs compared with manual compression. Indeed, the use of VCDs is associated with a new group of complications related to the devices themselves.