title: Vascular Closure Devices: Technical Tips, Complications, and Management.
abstract: Vascular closure devices (VCDs) are used to obtain hemostasis at the vascular access site while limiting the need for manual compression. They have gained significant popularity since their introduction in the mid-1990s. In the past 20 years, there has been a multitude of different devices introduced with various mechanisms of action. Manual compression remains the gold standard but can be very time consuming and painful for the patient. VCDs are advantageous in that they can reduce time to hemostasis and patient recovery and improve patient comfort. However, a large number of catheter-based procedures are performed without these closure devices owing to lack of operator familiarity, risk of complications, and cost. Most VCDs are approved for arteriotomies between 5 and 8F, with 1 device approved for up to 21F. Major complications include infection and limb ischemia. This article provides an update on currently approved VCDs, a brief overview of the literature, and our institutional experience with these devices.
authors.affiliation: Section of Vascular and Interventional Radiology, George Washington University Hospital, Washington, DC; Section of Vascular and Interventional Radiology, National Institutes of Health, Bethesda, MD. Electronic address: venkatesh.krishnasamy@nih.gov.
authors.forename: Venkatesh P
authors.initials: VP
authors.lastname: Krishnasamy
authors.affiliation: Department of Diagnostic Radiology, George Washington University Hospital, Washington, DC.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hagar
authors.affiliation: Department of Diagnostic Radiology, George Washington University Hospital, Washington, DC.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scher
authors.affiliation: Department of Diagnostic Radiology, George Washington University Hospital, Washington, DC.
authors.forename: Mamadou L
authors.initials: ML
authors.lastname: Sanogo
authors.affiliation: Section of Vascular and Interventional Radiology, George Washington University Hospital, Washington, DC.
authors.forename: Gaby E
authors.initials: GE
authors.lastname: Gabriel
authors.affiliation: Section of Vascular and Interventional Radiology, George Washington University Hospital, Washington, DC; Section of Vascular and Interventional Radiology, National Institutes of Health, Bethesda, MD; Department of Diagnostic Radiology, George Washington University Hospital, Washington, DC; Division of Vascular Surgery, George Washington University Hospital, Washington, DC.
authors.forename: Shawn N
authors.initials: SN
authors.lastname: Sarin
mesh_terms: D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D004867:Equipment Design; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D062666:Vascular Access Devices / Q000009:adverse effects*; D065506:Vascular Closure Devices / Q000009:adverse effects*
keywords: hemostasis; manual compression; vascular access; vascular closure device