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

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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.

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Abbreviations

ACT:

Activated clotting time

BMI:

Body-mass-index

GPI:

Glycoprotein IIb/IIIa inhibitor

MC:

Manual compression

NSTEMI:

Non-ST-elevation myocardial infarction

PCI:

Percutaneous coronary intervention

SOP:

Standard operating procedure

STEMI:

ST-elevation myocardial infarction

TIMI:

Thrombolysis in myocardial infarction

VCD:

Vascular closure device

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Medizinische Klinik I, Medical Faculty, University RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    Emilia Stegemann, Rainer Hoffmann, Berthold Stegemann & Nikolaus Marx

  2. Saint Luke’s Hospital, Kansas City, USA

    Steven Marso

  3. Medizinische Klinik B, Medical Faculty, University Dusseldorf, Düsseldorf, Germany

    Thomas Lauer

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  1. Emilia Stegemann
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  2. Rainer Hoffmann
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  4. Berthold Stegemann
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Correspondence to Emilia Stegemann.

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Stegemann, E., Hoffmann, R., Marso, S. et al. The frequency of vascular complications associated with the use of vascular closure devices varies by indication for cardiac catheterization. Clin Res Cardiol 100, 789–795 (2011). https://doi.org/10.1007/s00392-011-0313-4

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  • DOI: https://doi.org/10.1007/s00392-011-0313-4

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