title: [Use of a percutaneous suture-mediated closure system after 6 - 8F transfemoral approaches: results for 2200 patients].
abstract: OBJECTIVE
  The safety and effectiveness of a percutaneous suture-mediated closure system for achieving hemostasis using a transarterial femoral approach were investigated.
  
  
  METHODS
  A percutaneous suture closure system (Perclose/Proglide, Abbott Vascular, Redwood City, California) was used in 2200 patients (average age 67.5 ± 12.5 years) who had undergone an angiographic intervention. Vascular access sites (1331 retrograde, 869 antegrade) with a sheath size of between 6F and 8F were closed. Platelet aggregation was inhibited with 100 mg/d ASA and all patients additionally received 5000 IU heparin peri-interventionally. After application of the suture-mediated closure system and achievement of sufficient hemostasis, a light compression bandage was applied in all patients and 6 hours of bed rest were recommended. The puncture site of all patients was checked using color-coded duplex sonography post-interventionally (following day and after 6 weeks).
  
  
  RESULTS
  Immediate hemostasis was achieved in 2103/2200 patients (95.6 %). In the remaining 97/2200 cases, correct development of the suture was not possible, because of calcifications. In such cases, hemostasis was achieved by manual compression. Major complications (0.4 %) involved 3 infections that required vascular surgical debridement with the use of an interposition graft. In addition, there were 5 cases of secondary bleeding requiring transfusion. Minor complications (15.6 %) involved 3 (0.14 %) pseudoaneurysms, 256 (11.6 %) groin hematomas (up to max. 3 cm) and 85 (3.9 %) palpable suture granulomas.
  
  
  CONCLUSIONS
  At a puncture size of 6 - 8F, safe and effective hemostasis is possible with the percutaneous suture-mediated closure system.
authors.affiliation: Universitäten Kiel, Lübeck und Hamburg, Esmarschstr. 50, 25746 Heide. pkamusella@wkk-hei.de
authors.forename: P
authors.initials: P
authors.lastname: Kamusella
authors.forename: C
authors.initials: C
authors.lastname: Wissgott
authors.forename: R
authors.initials: R
authors.lastname: Andresen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology / Q000628:therapy; D000792:Angiography / Q000295:instrumentation*; D017130:Angioplasty / Q000295:instrumentation*; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000628:therapy*; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011312:Pressure; D011677:Punctures / Q000295:instrumentation; D015642:Radiology, Interventional / Q000295:instrumentation*; D012307:Risk Factors; D013536:Suture Techniques / Q000295:instrumentation*; D017211:Treatment Failure; D058106:Wound Closure Techniques / Q000295:instrumentation*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D001241:Aspirin