title: Vascular closure devices in stroke patients receiving tissue plasminogen activator: A retrospective analysis from an academic tertiary medical center and a teaching community hospital stroke database.
abstract: OBJECTIVE
  To determine the safety and effectiveness of vascular closure devices in prevention of access site complications in acute stroke patient receiving intravenous (IV) and/or intra-arterial (IA) IV tissue plasminogen activator (tPA).
  
  
  METHODS
  All patients with acute stroke onset treated with IV and/or IA tPA closed with vascular closure device and adult age (>18 years) were identified from an academic tertiary medical center and a teaching community hospital stroke database for 9 years (from March 2005 to June 2014).
  
  
  RESULTS
  A total of 69 patients were included in the study. The mean age was 68.86±16.70 years and 49.2% female. All accesses were under fluoroscopic guidance into the right common femoral artery. We observed a 5.8% complication rate in patients receiving IV and/or IA tPA closed with vascular closure device. Access site complications included 3 cases of hematoma and 1 case of residual oozing. One patient required transfusion due to access site hematoma. Three patients were on aspirin and heparin and 1 was on no prior anticoagulation.
  
  
  CONCLUSIONS
  Vascular closure device access site hemorrhagic complication rate in those receiving IV and/or IA tPA is low and similar to reported rates in those not receiving thrombolytic therapy. Vascular closure device use in patients receiving thrombolytic therapy is safe and effectively achieves hemostasis.
authors.affiliation: The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, United States. Electronic address: Mangaladevi_Patil@Brown.edu.
authors.forename: Mangaladevi S
authors.initials: MS
authors.lastname: Patil
authors.affiliation: The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, United States; Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, United States; Department of Diagnostic Imaging, Miriam Hospital, 164 Summit Ave, Providence, RI 02906, United States.
authors.forename: Mahesh V
authors.initials: MV
authors.lastname: Jayaraman
authors.affiliation: The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, United States; Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, United States; Department of Diagnostic Imaging, Miriam Hospital, 164 Summit Ave, Providence, RI 02906, United States.
authors.forename: Sun H
authors.initials: SH
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D065506:Vascular Closure Devices; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Endovascular; Stroke; Tissue plasminogen activator; Vascular closure device