The frequency of vascular complications associated with the use of vascular closure devices varies by indication for cardiac catheterization

Emilia Stegemann, Rainer Hoffmann, Steven Marso, Berthold Stegemann, Nikolaus Marx, Thomas Lauer

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Objective: This study aimed at exploring access site-related vascular complication rates associated with the use of the vascular closure device (VCD) Angio-Seal™ in an unselected patient population undergoing elective as well as emergency coronary angiography or intervention. Background: The VCD Angio-Seal™ is widely used to achieve hemostasis after diagnostic and interventional cardiac procedures. There are only little data on the frequency of vascular complications after the use of the VCD Angio-Seal™ in patients in non-elective settings. Method: In-hospital vascular complications were prospectively assessed in 4,653 consecutive cardiac catheterization procedures, which included 2,772 elective diagnostic and 960 elective percutaneous coronary interventions (PCI), and 921 emergency cardiac catheterizations in patients with NSTEMI/STEMI. In 2,077 procedures manual compression (MC) and in 2,576 procedures VCD was applied. Complication rates for manual compression and VCD use were studied and multivariate analyses performed to disclose predictors for access site-related vascular complications. Results: Vascular complication rates in patients receiving MC to achieve hemostasis were similar to those receiving a VCD (MC 3.4% vs. VCD 3.2%, p = n.s.). Separate analysis of vascular complication rates for subgroups revealed a significant reduction in vascular complications for the PCI group using a VCD (MC 7.7% vs. VCD 3.2%, p = 0.003). In emergencies VCD use lead to a rise in vascular complications (MC 0.9% vs. VCD 6.3%, p < 0.001). Conclusions: In contrast to elective settings, the risk of access site-related vascular complications is significantly increased after application of the VCD Angio-Seal™ in patients undergoing emergency catheterizations for NSTEMI/STEMI compared with manual compression.

Original languageEnglish (US)
Pages (from-to)789-795
Number of pages7
JournalClinical Research in Cardiology
Volume100
Issue number9
DOIs
StatePublished - Sep 1 2011

Keywords

  • Acute coronary syndrome
  • Coronary interventions
  • Vascular closure devices
  • Vascular complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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