Vascular closure

Summary

The use of vascular closure devices is widespread both with operators who carry out their interventions via the femoral approach and those using radial access. Interventionists performing arterial access procedures should be not only aware of when and how to use them but also of the advantages and disadvantages of each device, eventually predicting and treating any complications which may occur. In this chapter we aim to provide an overview of the currently available devices, focusing on how they work, on their efficacy in achieving haemostasis, on any risks associated with their use, and on the data available for each device. We also compare the published registries and meta-analyses and look at the current ACC/AHA guidelines for vascular closure. The majority of devices in this chapter are described as used for coronary and peripheral interventions. Vascular closure related to trancatheter aortic valve implantation is covered in detail in the chapter Transcatheter aortic valve implantation.

Introduction

Percutaneous treatment for coronary artery disease has constantly expanded over the last two decades. With improvements in techniques and equipment, a large number of patients with ischaemic heart disease are undergoing invasive vascular interventions.

Approximately 7 million invasive vascular procedures are performed worldwide each...