Intentional combination of ProGlide and Angio-Seal for femoral access haemostasis in transcatheter aortic valve replacement
Journal
International journal of cardiology
Journal Volume
293
Pages
76
Date Issued
2019-10-15
Abstract
Background: To describe and evaluate the intentional combination of Angio-Seal (AS) and Perclose ProGlide (PP) in achieving haemostasis in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR).
Methods: This study cohort was divided into two groups: dual PP versus one AS with one PP (AS + PP) used for common femoral artery haemostasis. The baseline, procedural characteristics and all outcomes (defined according toVARC-2 criteria) were prospectively collected and retrospectively compared.
Results: Overall, a total of 151 consecutive patients (68 men; 80.9 ± 7.3 years old) were evaluated. Of these, 51 patients (33.8%) underwent TAVR using the dual PP, and 100 (66.2%) using one AS with one PP. There were no significant differences in the baseline characteristics of both patient groups, except higher incidence of chronic pulmonary disease in dual PP group (21.6% vs 7%, P = 0.009). Patients in AS + PP group had lower rate of arterial stricture (21.6% vs 8%, P = 0.017), arterial dissection (13.7% vs 4.0%), requiring endovascular intervention for puncture site issues (21.6% vs 9.0%, P = 0.031). Less procedural time (139.8 ± 36.9vs97.9 ± 31.4 min, P < 0.001) & contrast medium consumption (223.9 ± 88.3vs174.1 ± 49.7 ml, P < 0.001) were also observed in AS+PP group. There were no statistically significant differences between 2 groups in regards of closure device failure, major and minor vascular complications, nor major and minor bleeding.
Conclusions: Intentional combination of one PP and one AS for femoral access haemostasis in patients undergoing TAVR is feasible and safe, with low risk of vascular and bleeding complications.
Subjects
TAVR
Vascular closure
Vascular complicatio
SDGs
Other Subjects
contrast medium; aged; aortic valve disease; artery dissection; artery occlusion; Article; bleeding; chronic lung disease; clinical outcome; cohort analysis; controlled study; endovascular surgery; female; femoral artery; fluoroscopy; hemostasis; human; incidence; major clinical study; male; operation duration; priority journal; prosthesis complication; retrospective study; surgical technique; transcatheter aortic valve implantation; vascular access; vascular disease; very elderly; devices; femoral artery; heart catheterization; hemostasis; hemostatic technique; multimodality cancer therapy; physiology; procedures; prospective study; surgery; transcatheter aortic valve implantation; treatment outcome; Aged; Aged, 80 and over; Cardiac Catheterization; Cohort Studies; Combined Modality Therapy; Female; Femoral Artery; Hemostasis; Hemostatic Techniques; Humans; Male; Prospective Studies; Retrospective Studies; Transcatheter Aortic Valve Replacement; Treatment Outcome
Publisher
ELSEVIER IRELAND LTD
Type
journal article