Published online Sep 28, 2018. doi: 10.4329/wjr.v10.i9.108
Peer-review started: April 27, 2018
First decision: June 14, 2018
Revised: August 6, 2018
Accepted: August 23, 2018
Article in press: August 24, 2018
Published online: September 28, 2018
Processing time: 154 Days and 6.6 Hours
To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using ExoSeal vascular closure devices (VCDs).
Between November 2015 and April 2017, we performed 179 diagnostic and interventional angiographic procedures via a common femoral arterial access. The ExoSeal VCD was used at the puncture site to achieve hemostasis in 125 patients. We evaluated the technical and procedural success rates, the complications, and the factors affecting the hemostasis time of the ExoSeal VCDs.
Technical and procedural successes were achieved in 176 cases (98.0%) and 128 cases (71.5%), respectively. Device failure occurred in 3 (1.7%) cases. In 1 case (0.6%) a small hematoma developed, but there were no major complications. Among the hemostasis-relevant variables, a history of drinking alcohol, low platelet (PLT) count, and high prothrombin time-international normalized ratio (commonly known as PT-INR) values were the statistically significant predictors of the need for longer manual compression (MC). There was no difference in the success rates between the repeat and single ExoSeal procedure groups, and repeated use of the ExoSeal did not affect hemostasis time.
The ExoSeal VCD effectively achieves hemostasis, with few complications. Longer light MC may be needed with alcohol drinkers, low PLT count, and high PT-INR values.
Core tip: This study aimed to report the experience of closure of the femoral artery over a 17-mo period using ExoSeal vascular closure devices (VCDs). Technical and procedural successes were achieved in 176 cases (98.0%) and 128 cases (71.5%), respectively, while device failure occurred in only 3 (1.7%) cases. Repeated use of the ExoSeal did not affect hemostasis time or success rate. Thus, ExoSeal VCD is a simple, safe and effective device for achieving hemostasis with few complications. However, longer light manual compression may be needed with alcohol drinkers, low platelet counts, and high prothrombin time-international normalized ratio values.