Suitability of Exoseal vascular closure device for antegrade femoral artery puncture site closure.
OBJECTIVE
To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery.


METHODS
In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36 h after angiography to check for vascular complications.


RESULTS
In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery.


CONCLUSIONS
The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.
Department of Diagnostic and Interventional Radiology, Klinikum Ingolstadt, Krumenauerstraße 25, 85049 Ingolstadt, Germany. christopher.schmelter@klinikum-ingolstadt.de
Christopher
C
Schmelter
Andrea
A
Liebl
Nektarios
N
Poullos
Volker
V
Ruppert
Dierk
D
Vorwerk
D000368:Aged; D000792:Angiography; D001458:Bandages; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011677:Punctures; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography