This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kalapatapu, V. R. Articles by Eidt, J. F. Search for Related Content PubMed PubMed Citation Articles by Kalapatapu, V. R. Articles by Eidt, J. F. Social Bookmarking                         What's this?

Techniques for Managing Complications of Arterial Closure Devices

University of Arkansas for Medical Sciences, Little Rock, AR

Ahsan T. Ali, MD

University of Arkansas for Medical Sciences, Little Rock, AR

Farzad Masroor, BS

University of Arkansas for Medical Sciences, Little Rock, AR

Mohammed M. Moursi, MD

University of Arkansas for Medical Sciences, Little Rock, AR

John F. Eidt, MD

University of Arkansas for Medical Sciences, Little Rock, AR, eidtjohnf{at}uams.edu

According to data reported by the American Heart Association, more than 5 million diagnostic and therapeutic catheterizations are performed each year in the United States. The number of catheterizations has tripled since 1979. It has been estimated that complications related to the access site result in more than 75,000 surgical procedures annually. Thus, improved management of the access site itself is essential to achieve the greater goals of improved care and reduced cost. Manual compression directly over the site of arterial puncture usually results in adequate hemostasis but has several significant drawbacks. Manual compression is uncomfortable for the patient, is fatiguing and time-consuming for staff, and necessitates several hours of costly in-hospital observation. In addition, it may be ineffective in achieving hemostasis, especially in the setting of systemic anticoagulation or following the use of large-bore devices. Based on the perceived need for an improved method of managing the arterial access site following catheterization, various vascular sealing devices have been developed. There are at least 8 (and the number is increasing) hemostatic vascular closure devices that are currently approved by the FDA for access site closure after femoral arterial catheterization. The chief advantage attributed to vascular sealing devices is accelerated access site hemostasis, even in the setting of anticoagulation, leading to earlier ambulation and hospital discharge following arterial catheterization. The most important drawbacks related to vascular sealing devices include the cost of the devices and the possibility of increased access site complications. Despite the paucity of properly designed studies supporting their use, it is estimated that over one million vascular sealing devices are used annually in the United States, a number that has increased dramatically in the past 5 years.In this review, we present a brief description of the design and function of the most widely used devices, describe the most common mechanisms of failure, and recommend strategies for management of access site complications including hemorrhage, arterial obstruction, and infection.

Vascular and Endovascular Surgery, Vol. 40, No. 5, 399-408 (2006)
DOI: 10.1177/1538574406293760


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. L. Kirkwood, C.-M. Wahlgren, and T. R. Desai The Use of Arterial Closure Devices for Incidental Arterial Injury Vascular and Endovascular Surgery, October 1, 2008; 42(5): 471 - 476. [Abstract] [PDF]