"Double wire" angio-seal closure technique after balloon aortic valvuloplasty.
OBJECTIVE
To report the feasibility of a collagen-mediated closure device using a modified Angio-Seal closure technique for access site management following percutaneous balloon aortic valvuloplasty (BAV).


BACKGROUND
With the advent of percutaneous aortic valve replacement therapies, there has been a resurgence of interest in BAV procedures. Vascular complications, including bleeding, are a common source of morbidity post procedure as a result of the requirement for large bore femoral artery access. The use of vascular closure devices may reduce bleeding complications.


METHODS
We describe a new technique for vascular closure in this setting. At the conclusion of the valvuloplasty procedure, two 0.035'' wires are inserted through the femoral artery sheath. A conventional collagen-mediated closure device (8F Angio-Seal) is deployed over the first wire and along side the second wire. If immediate hemostasis is not achieved, a second device is loaded onto the second wire and deployed to achieve hemostasis.


RESULTS
Percutaneous BAV was performed in 21 patients. Hemostasis was successfully achieved in all patients with either a single 8F Angio-Seal closure device (18 patients) or after placement of a second device (three patients).


CONCLUSIONS
The modified "Double Wire" Angio-Seal technique is a feasible method for hemostasis following percutaneous BAV.
Bui
Quang T
QT
Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Kolansky
Daniel M
DM
Bannan
Amr
A
Herrmann
Howard C
HC
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D008297:Male; D011677:Punctures; D012720:Severity of Illness Index; D016896:Treatment Outcome