Pre-close technique of percutaneous closure for delayed hemostasis of large-bore femoral sheaths

J Interv Cardiol. 2018 Aug;31(4):504-510. doi: 10.1111/joic.12490. Epub 2018 Feb 5.

Abstract

Advancement of coronary interventions and portable hemodynamic device requires placement of large bore sheaths. Access for large caliber sheaths, its placement, maintenance, and hemostasis is very challenging and one of the key ailments for successful procedures. Traditional hemostasis method is manual compression, which is unattractive due to its own limitations and subsequent complications. Single closure device for sheath size larger than 8 French (Fr) is not available. We performed retrospective analysis of large cohort of patients with 13, 14 Fr sheaths (Impella device [ABIOMED]) percutaneous closure with the use of two Perclose devices. Two perclose devices were placed in a "Preclose" fashion and hemostasis was obtained few days later once hemodynamic support was weaned off by deployment of perclose sutures.

Keywords: closure device; impella; mechanical circulatory; sheath complication.

MeSH terms

  • Aged
  • Catheterization, Peripheral* / adverse effects
  • Catheterization, Peripheral* / methods
  • Equipment Design
  • Female
  • Femoral Artery* / injuries
  • Femoral Artery* / surgery
  • Hemostasis, Surgical* / instrumentation
  • Hemostasis, Surgical* / methods
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / instrumentation*
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Access Devices / adverse effects*
  • Vascular Closure Devices*