title: [Arterial closure devices. What device for which clinical situation?].
abstract: OBJECTIVE
  Access site complications after endovascular catheterization sometimes require open surgery and negatively impair safety, patient comfort and reimbursement. Increasing numbers of procedures and patients with multiple anticoagulants as well as cost pressure explain the demand for an immediate and stable access site closure.
  
  
  METHODS
  Manual compression followed by compression bandage and bed rest for 4-24 h is still the gold standard but is unable to prevent access site complications in all cases.
  
  
  METHODS
  Arterial vascular closure devices allow immediate and stable closure of the puncture channel either by suture or by implantation of occluding foreign bodies or gluing fluids.
  
  
  METHODS
  The safety has been proven in several clinical trials. The main advantage lies in closing large lumen access sites without surgery and in patients treated with multiple anticoagulants as well as in outpatient procedures.
  
  
  RESULTS
  They have become a valuable supplement to the interventional arsenal.
  
  
  CONCLUSIONS
  The physician, however, has to decide between different systems and mechanisms with respect to patient constitution, selected access vessel and level of calcification and diameter. Furthermore, all systems require a defined training prior the first use.
authors: Institut für Klinische Radiologie, Klinikum Innenstadt der Ludwig-Maximilians-Universität München, Medizinische Poliklinik, Pettenkoferstrasse 8a, Munich, Germany. Marcus.Treitl@med.uni-muenchen.de
authors: M
authors: M
authors: Treitl
authors: K M
authors: KM
authors: Eberhardt
authors: D
authors: D
authors: Maxien
authors: B
authors: B
authors: Behrends
authors: M F
authors: MF
authors: Reiser
mesh_terms: D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004867:Equipment Design; D006470:Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D058729:Peripheral Arterial Disease / Q000209:etiology* / Q000517:prevention & control*