title: Appropriate hemostasis by routine use of ultrasound echo-guided transfemoral access and vascular closure devices after lower extremity percutaneous revascularization.
abstract: To assess the safety and efficacy of routine use of ultrasound-guided puncture and the use of vascular closure device (VCD) in patients undergoing endovascular therapy (EVT) through femoral access. This was a single-center, non-randomized clinical study that enrolled 513 patients undergoing EVT via femoral artery access in which hemostasis was achieved using VCDs (406-patient EXOSEAL arm and 107-patient PROGLIDE arm). All cases were performed by routine use of ultrasound-guided access. The primary endpoint was the achievement of hemostasis without periprocedural and 30-day incidence of major or minor access site-related complications. The primary endpoint was achieved in 91.6 % of the cases (470/513) with a higher success rate in the EXOSEAL arm (93.6). Major complications were observed in 5 patients (0.9 %) in total cohort and 3 patients (0.7 %) treated with EXOSEAL arm vs. 2 patients (1.8 %) with PROGLIDE arm (p = 0.32). Combined treatment two VCDs with the routine ultrasound guidance access for patients who underwent the EVT procedure showed high efficacy and safety outcomes.
authors.affiliation: Department of Cardiology, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522, Japan. masahiko-fujihara@themis.ocn.ne.jp.|Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University, Fukuoka, Japan. masahiko-fujihara@themis.ocn.ne.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fujihara
authors.affiliation: Department of Medical Engineering, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Haramitsu
authors.affiliation: Department of Medical Engineering, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohshimo
authors.affiliation: Department of Medical Engineering, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yazu
authors.affiliation: Department of Medical Engineering, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Izumi
authors.affiliation: Department of Cardiology, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Higashimori
authors.affiliation: Department of Cardiology, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yokoi
mesh_terms: D000368:Aged; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000601:surgery; D018084:Ultrasonography, Interventional / Q000379:methods*; D065506:Vascular Closure Devices / Q000009:adverse effects
keywords: Endovascular therapy; Peripheral artery disease; Ultrasound guided access; Vascular closure devices