title: The use of vascular closure devices outside the catheterization laboratory after neurointerventional procedures is safe and effective: evidence from a retrospective study.
abstract: OBJECTIVE
  To investigate the feasibility and safety of vascular closure device (VCD) deployment outside the catheterization laboratory.
  
  
  METHODS
  Medical records were reviewed of all 799 patients (396 men; mean age 56 ± 16 years) who underwent deployment of 918 VCDs following diagnostic or therapeutic neurointerventional procedures over a 2-year period at 2 comprehensive stroke centers. The rates of major vascular complications in patients undergoing VCD deployment in and outside the catheterization laboratory were compared. Major vascular complications were adjudicated using definitions by the Society of Interventional Radiology; comparisons were made between different procedure types and closure devices.
  
  
  RESULTS
  During the observation period, 103 (11.2%) of 918 VCD deployments were performed outside the catheterization laboratory. Age, gender, procedure type, and device types were not different between the groups. A total of 10 (1.1%) major vascular complications occurred, including dissection requiring angioplasty (n = 1), hematoma requiring blood transfusion (n = 4), pseudoaneurysm requiring thrombin injection (n = 2), and lower limb ischemia necessitating surgical removal of the VCD (n = 3). Rates of major vascular complications were not significantly different between VCDs deployed inside the catheterization laboratory [1.0% (8/815)] compared to outside [1.9% (2/103), p = 0.3].
  
  
  CONCLUSIONS
  VCD deployment outside the catheterization laboratory does not increase the rate of major vascular complications and may be an alternative approach for femoral artery hemostasis when VCD deployment needs to be deferred.
authors.affiliation: Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota 55455, USA.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Khatri
authors.forename: Nassir
authors.initials: N
authors.lastname: Rostambeigi
authors.forename: Ameer E
authors.initials: AE
authors.lastname: Hassan
authors.forename: Blake
authors.initials: B
authors.lastname: Carlson
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Rodriguez
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002561:Cerebrovascular Disorders / Q000628:therapy*; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects; D004867:Equipment Design; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D015999:Multivariate Analysis; D011677:Punctures; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome