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16/07/2019 -  

Femoral Arterial Puncture Management After Percutaneous Coronary Procedures: A Comparison of Clinical Outcomes and Patient Satisfaction Between Manual Compression and Two Different Vascular Closure Devices


Duffin D, et al. Femoral arterial puncture management after percutaneous coronary procedures: A comparison of clinical outcomes and patient satisfaction between manual compression and two different vascular closure devices. J Invasive Cardiol. 2001;13(5):354-62.

DESCRIPTION

  • Prospective, demographic, periprocedural, and late follow-up data for 1.500 patients undergoing PCI were collected from patients receiving femoral artery closure

  • Manual compression was used in 471 patients; the Perclose device in 492; and the Angio-Seal device in 537

  • Periprocedural, post-procedural and post-hospitalization endpoints were: 1) safety of closure method; 2) efficacy of closure method; and 3) patient satisfaction


KEY FINDINGS

  • Patients treated with the Perclose device experienced more complications than those treated with the Angio-Seal device (p=0.008) or with manual compression (p=0.06)

  • Use of the Angio-Seal device had a higher rate of successful deployment and shorter hemostasis time with no increase in bleeding complications throughout follow-up

  • Overall, the Angio-Seal device performed better than the Perclose device or manual compression in reducing time to ambulation and length of stay among patients undergoing diagnostic procedures

  • Use of the Angio-Seal device achieved superior 30-day patient satisfaction and patient assessment of wound healing with less discomfort compared to the Perclose device


CONCLUSION

  • Prolonged bed rest and access site complications can be challenging for patients. This study shows a decrease in bed rest and complication rates. The use of a vascular closure device to achieve hemostasis increased patient satisfaction and comfort after PCI procedures.


 

A Randomized Trial Comparing Compression, Perclose ProGlide™ and Angio-Seal VIP for Arterial Closure Following Percutaneous Coronary Intervention: The CAP Trial


Martin JL, et al. A randomized trial comparing compression, Perclose ProGlide and Angio-Seal VIP for arterial closure following percutaneous coronary intervention: The CAP trial. Catheter Cardiovasc Interv. 2008;71(1):1-5.

DESCRIPTION

Objective: Compare the time to hemostasis, time to ambulation, patient satisfaction and vascular complications

  • Prospective randomized single center study conducted at Bryn Mawr Health, Bryn Mawr, Pennsylvania

  • 200 patients who underwent PCI were randomized to receive vascular closure via manual compression, the Perclose ProGlide device, or the Angio-Seal VIP device

  • Patients evaluated pre-discharge or at 24 hours post-procedure. Patient satisfaction questionnaire given at discharge, and at one and four weeks post-procedure.


KEY FINDINGS

  • Procedural success was significantly greater with the Angio-Seal VIP device compared to the Perclose ProGlide device (100% versus 84%)

  • Time to hemostasis was significantly shorter with the Angio-Seal VIP device compared to the Perclose ProGlide device (5 minutes compared to 11 minutes) — not including the 10 Perclose ProGlide device failures

  • Time to ambulation was shortest with the Angio-Seal VIP device and longest with manual compression

  • Angio-Seal VIP had a high rate of deployment success, allowed for earlier ambulation compared to both compression and Perclose ProGlide and was associated with greater patient satisfaction compared with compression

  • No significant difference in complication rates was found among the closure methods.


CONCLUSION

  • Angio-Seal VIP had a 100% deployment success rate, allowed for earlier ambulation and had high patient satisfaction