title: Pre-closure of Large-Sized Arterial Access Sites in Adults Undergoing Transcatheter Structural Interventions.
abstract: BACKGROUND
  Patients undergoing structural heart interventions often require large-sized sheath insertion into femoral arteries and veins. Clinical outcome data on the use of suture-mediated devices for large femoral arterial access in structural heart interventions is limited. We assessed the efficacy of the Perclose™ (Abbott Vascular Devices, Santa Clara, CA, USA) suture-mediated device using the pre-closure technique in achieving hemostasis in femoral arterial access sites following large sheath insertion (≥8 Fr).
  
  
  METHODS
  One hundred consecutive patients underwent 101 femoral artery access sites closures with the Perclose device using the pre-closure technique. Sixty-two percent of the patients were male and their mean (SD) age was 52 (±26) years. All patients received heparin.
  
  
  RESULTS
  Mean arterial access site sheath diameter was 13 ± 2 Fr. Immediate hemostasis was achieved in 96/101 (96%) procedures (≤2 min). Two patients (2%) had access site-related complications requiring further interventions. On clinical follow up [mean (SD) follow-up of 24 (±12) months and median follow-up of 8.5 months], no complications were seen in the arterial access sites.
  
  
  CONCLUSIONS
  Pre-closure of large-size femoral arterial access sheath sites using the suture-mediated Perclose device is efficacious in achieving rapid hemostasis in patients undergoing structural interventions. On 1-year follow-up, there were no arterial access site complications requiring further investigations or interventions.
authors.affiliation: Central Manchester University Hospitals, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Hamid
authors.forename: Tawfiq R
authors.initials: TR
authors.lastname: Choudhury
authors.forename: Bernard
authors.initials: B
authors.lastname: Clarke
authors.forename: Vaikom S
authors.initials: VS
authors.lastname: Mahadevan