title: Safety and efficacy of percutaneous femoral artery access followed by Mynx closure in cerebral neurovascular procedures: a single center analysis.
abstract: OBJECTIVE
  Percutaneous transfemoral arterial procedures rely on a variety of vascular closure methods. We studied closure success and complications after using the Mynx vascular closure device in cerebral neurovascular procedures.
  
  
  METHODS
  We prospectively analyzed patients undergoing diagnostic cerebral angiogram or neurointervention with arteriotomy closure using the Mynx device. Patient demographics and procedural factors were recorded. Statistical analyses compared groups and identified predictors of device failure and complication.
  
  
  RESULTS
  A total of 766 patients, 59% women, mean age 55.5 years (SD 14.2), mean body mass index (BMI) 29.1 kg/m(2) (SD 7.4), underwent 937 neurovascular procedures in a 10 month period. Device success was achieved in 92% of patients; lower BMI, higher number of antithrombotic medications, larger sheath size, and performance of a neurointerventional procedure predicted Mynx failure. Complications occurred in 2.45% of procedures, with older age, lower BMI, higher number of antithrombotic medicines used, higher international normalized ratio, lower platelet count, and Mynx device failure conferring an increased risk of complication.
  
  
  CONCLUSIONS
  The Mynx device is safe and effective for cerebral neurovascular procedures. However, specific patient populations may warrant particular attention and thorough consideration of risks and benefits prior to employing the Mynx device for femoral arteriotomy closure.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Grandhi
authors.affiliation: Department of Neurosurgery, East Carolina University, Greenville, North Carolina, USA.
authors.forename: Hilal
authors.initials: H
authors.lastname: Kanaan
authors.affiliation: Department of Anesthesiology, University of Washington Affiliated Hospitals, Seattle, Washington, USA.
authors.forename: Aalap
authors.initials: A
authors.lastname: Shah
authors.affiliation: Department of Neurological Surgery, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Gillian
authors.initials: G
authors.lastname: Harrison
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bonfield
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Tudor
authors.initials: T
authors.lastname: Jovin
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Jankowitz
authors.affiliation: Pennsylvania Brain and Spine Institute, Mars, Pennsylvania, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
mesh_terms: D001807:Blood Vessel Prosthesis; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002533:Cerebral Angiography; D020878:Device Removal; D005260:Female; D005263:Femoral Artery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D011092:Polyethylene Glycols; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents; D011092:Polyethylene Glycols
keywords: Angiography; Artery; Complication; Device; Intervention