title: Using vascular closure devices following out-of-hospital cardiac arrest?
abstract: OBJECTIVE
  Despite a generally broad use of vascular closure devices (VCDs), it remains unclear whether they can also be used in victims from out-of-hospital cardiac arrest (OHCA) treated with mild therapeutic hypothermia (MTH).
  
  
  METHODS
  All victims from OHCA who received immediate coronary angiography after OHCA between January 1(st) 2008 and December 31(st) 2013 were included in this study. The operator decided to either use a VCD (Angio-Seal™) or manual compression for femoral artery puncture. The decision to induce MTH was based on the clinical circumstances.
  
  
  RESULTS
  76 patients were included in this study, 46 (60.5%) men and 30 (39.5%) women with a mean age of 64.2 ± 12.8 years. VCDs were used in 26 patients (34.2%), and 48 patients (63.2%) were treated with MTH. While there were significantly more overall vascular complications in the group of patients treated with MTH (12.5% versus 0.0%; p=0.05), vascular complications were similar between patients with VCD or manual compression, regardless of whether or not they were treated with MTH.
  
  
  CONCLUSIONS
  In our study, the overall rate of vascular complications related to coronary angiography was higher in patients treated with mild therapeutic hypothermia, but was not affected by the application of a vascular closure device. Therefore, our data suggest that the use of VCDs in victims from OHCA might be feasible and safe in patients treated with MTH as well, at least if the decision to use them is individually carefully determined.
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Christ
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Katharina Isabel
authors.initials: KI
authors.lastname: von Auenmueller
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Liebeton
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Grett
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dierschke
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Jan Peter
authors.initials: JP
authors.lastname: Noelke
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Irini Maria
authors.initials: IM
authors.lastname: Breker
authors.affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Trappe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006489:Hemostatic Techniques / Q000009:adverse effects; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011677:Punctures; D012189:Retrospective Studies; D065506:Vascular Closure Devices / Q000009:adverse effects / Q000706:statistics & numerical data
keywords: coronary angiography; mild therapeutic hypothermia; out-of-hospital cardiac arrest; resuscitation; vascular closure device