title: Single-Center Experience Comparing the Application of Small-Caliber versus Large-Caliber Arterial Access Closure in a Consecutive Series of Patients.
abstract: OBJECTIVE
  To compare the closure of ≤ 8-F versus 9-F to 12-F femoral access using the 8-F Angio-Seal VIP device (St. Jude Medical, Inc, St. Paul, Minnesota).
  
  
  METHODS
  In this investigator-initiated, retrospective analysis, a consecutive series of 137 patients (n = 92 male patients [67.2%]; overall mean age, 71.0 y ± 9.8) was evaluated. Common femoral artery access was performed in all patients, and either unfractionated heparin or bivalirudin was used for anticoagulation. Access site complications were defined as follows: type 0, no bleeding; type 1, no actionable bleeding; type 2, actionable bleeding.
  
  
  RESULTS
  The 8-F Angio-Seal VIP device was used for closure of ≤ 8-F femoral access in 76 patients (55.5%) and for 9-F to 12-F femoral access in 61 patients (44.5%). Access site complications were observed after 8-F Angio-Seal deployment in 11 patients (8.0%) (≤ 8 F, n = 5 [6.6%]; 9-12 F, n = 6 [9.8%]; P = .54). Comparing ≤ 8-F with 9-F to 12-F femoral access, type 1 complications were observed in 3 and 6 patients (P = .19) and type 2 complications were observed in 2 and 0 patients (P = .50), respectively. All type 1 complications were managed by applying external compression. Type 2 complications (n = 2 pseudoaneurysms) were treated with thrombin injection in 1 patient and secondary percutaneous intervention in 1 patient.
  
  
  CONCLUSIONS
  Use of the 8-F Angio-Seal for the closure of > 8-F femoral access is safe and effective. Complication rates when using the 8-F Angio-Seal for closure of ≤ 8-F and 9-F to 12-F femoral access are comparable.
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 N. Kendall Drive, Miami, FL 33176.. Electronic address: fredericbaumann@hotmail.com.
authors.forename: Frederic
authors.initials: F
authors.lastname: Baumann
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 N. Kendall Drive, Miami, FL 33176.
authors.forename: Timothy
authors.initials: T
authors.lastname: Yates
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 N. Kendall Drive, Miami, FL 33176.
authors.forename: Ripal
authors.initials: R
authors.lastname: Gandhi
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 N. Kendall Drive, Miami, FL 33176.
authors.forename: James
authors.initials: J
authors.lastname: Benenati
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 N. Kendall Drive, Miami, FL 33176.
authors.forename: Constantino
authors.initials: C
authors.lastname: Pena
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 N. Kendall Drive, Miami, FL 33176.
authors.forename: Barry T
authors.initials: BT
authors.lastname: Katzen
mesh_terms: D000368:Aged; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005263:Femoral Artery / Q000187:drug effects / Q000601:surgery*; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011677:Punctures / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000295:instrumentation*
chemical_list: D006490:Hemostatics