1. ProGlide-AngioSeal versus ProGlide-FemoSeal for vascular access hemostasis posttranscatheter aortic valve implantation.
- Author
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Samy M, Landt M, Mankerious N, Kurniadi A, Alotaibi S, Toelg R, Abdel-Wahab M, Nef H, Allali A, Richardt G, and Elbasha K
- Subjects
- Humans, Male, Female, Retrospective Studies, Treatment Outcome, Aged, Aged, 80 and over, Time Factors, Risk Factors, Aortic Valve surgery, Aortic Valve physiopathology, Aortic Valve diagnostic imaging, Suture Techniques adverse effects, Femoral Artery diagnostic imaging, Hemorrhage etiology, Hemorrhage prevention & control, Aortic Valve Stenosis surgery, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis physiopathology, Hemostatic Techniques instrumentation, Hemostatic Techniques adverse effects, Registries, Vascular Closure Devices, Punctures, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Catheterization, Peripheral adverse effects
- Abstract
Background: The hybrid strategy combining plug-based and suture-based vascular closure devices (VCD) was introduced as a promising technique for vascular access hemostasis after transcatheter aortic valve implantation (TAVI) with satisfactory outcomes. However, data comparing two plug-based VCDs each in the combination with a suture-based VCD, namely ProGlide/AngioSeal (P/AS) with ProGlide/FemoSeal (P/FS) VCDs, is still lacking., Aims: To compare the 30-day outcome of the hybrid strategy using P/AS versus P/FS for vascular access site closure after TAVI., Methods: A retrospective single-center observational study included 608 patients recruited from a prospective TAVI registry between 2016 and 2022. The composite endpoint was defined as any VCD-related major vascular complications and/or bleeding more than type 1 according to Valve Academic Research Consortium criteria., Results: The current study reported a significantly higher rate of composite endpoint in P/AS group, which was driven by a higher rate of major bleeding (5.4% vs. 1.4%, p = 0.036). We also found a higher rate of VCD-related minor bleeding in P/AS group (16.3% vs. 8.1%, p = 0.013). Successful access site hemostasis was achieved in 71.7% of P/AS group versus 83.1% in P/FS group (p = 0.006). The presence of anterior wall calcification at the access site was significantly associated with the composite endpoint (adj odds ratio 2.49; 95% confidence interval (1.08-5.75), p = 0.032)., Conclusion: The hybrid strategy for large bore vascular access closure using P/FS showed a potentially better 30-day outcomes compared with P/AS. The presence of anterior calcification at the access site carries a significant risk of VCD-related complications., (© 2024 Wiley Periodicals LLC.)
- Published
- 2024
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