Case-controlled comparison of a percutaneous collagen arteriotomy closure device versus manual compression after liver chemoembolization.
OBJECTIVE
To compare complications and outcomes between the use of the Duett collagen closure device after one or multiple deployments and manual compression in patients treated with transcatheter arterial chemoembolization (TACE) for primary or metastatic liver cancer.


METHODS
A database of 214 patients who underwent a total of 426 TACE procedures between July 2001 and July 2003 was retrospectively analyzed with regard to the use of the Duett closure device to obtain hemostasis. The Duett device was used in 211 cases (121 patients), whereas manual compression was performed in 215 cases (93 patients). Primary endpoints included complications related to hemostasis, time to hemostasis (TTH), time to ambulation (TTA), and time to discharge (TTD). Risk factors were tested for correlation with complications (P < .05). Other endpoints included descriptive data regarding the Duett treatment group.


RESULTS
Only minor complications were observed in both groups, without a statistically significant difference (P = .16). The mean TTH and TTA were significantly shorter (P < .0001) in the Duett group, whereas there was no difference in TTD between groups (P = .59). Reaccessing the same arterial site for separate procedures was not a significant risk factor for complications in the Duett group (P < .0001).


CONCLUSIONS
The Duett closure device achieves similar safety and efficacy as manual compression in this distinct group of patients. In addition, this device can be safely and repetitively deployed at the arteriotomy site after each TACE procedure.
Hong
Kelvin
K
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 North Wolfe Street, Blalock 545, Baltimore, Maryland 21287, USA. khong1@jhmi.edu
Liapi
Eleni
E
Georgiades
Christos S
CS
Geschwind
Jean-Francois H
JF
D000704:Analysis of Variance; D000792:Angiography; D016022:Case-Control Studies; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation*; D016009:Chi-Square Distribution; D003094:Collagen / Q000627:therapeutic use*; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery; D006489:Hemostatic Techniques; D006801:Humans; D007866:Leg / Q000098:blood supply; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D003094:Collagen