What are vascular closure devices?
Once a minimally invasive artery procedure has been performed, the interventional radiologist will remove the devices used during the procedure, such as catheters or sheaths. At this point, patients usually experience some minor bleeding at the arterial access point for the procedure. Physicians tend to stop this bleeding using a technique called manual compression, in which they manually apply pressure to the site for 15-20 minutes. The patient then has to stay immobile for few hours.
Although this method generally works well, it is time-consuming and often uncomfortable for the patient. Further, this technique is not effective in some patients.
Vascular closure devices provide an alternative to manual compression. They are specially designed to stop bleeding more quickly, which is both more comfortable for patients and allows them to start moving around sooner. There are multiple types of vascular closure devices, but all of them are like a small stamp within or next to the artery puncture site.
Why use them?
Using vascular closure devices causes less pain and discomfort to patients compared to manual compression. These devices also stop bleeding more quickly, meaning that, following a procedure, patients can move about and leave the hospital sooner than if other techniques had been used.
What are the risks?
Complications can occur, but these are rare. The most common complication is that the device fails (which occurs in less than 6% of cases). When this happens, the physician must immediately resort to manual compression. Sometimes the bleeding occurs after some delay, but this also involves applying simple manual compression to the site. Most of the devices entail a small risk of a blockage in the target artery. The risk of infection is very low (less than 1%).
Bibliography
1. D. Scheinert MD, et al., The Safety and Efficacy of an Extravascular, Water-Soluble Sealant for Vascular Closure: Initial Clinical Results for Mynx, Catheterization and Cardiovascular Interventions 2007; 70: 627-633.
2. Abu-Fadel MS, Sparling JM, Zacharias SJ, et al., Fluoroscopy vs. traditional guided femoral arterial access and the use of closure devices: A randomized controlled trial, Catheter Cardiovasc Interv 2009; 74: 533–539.