Femoral arterial puncture management after percutaneous coronary procedures: a comparison of clinical outcomes and patient satisfaction between manual compression and two different vascular closure devices

J Invasive Cardiol. 2001 May;13(5):354-62.


Background: Vascular access site management is crucial to safe, efficient and comfortable diagnostic or interventional transfemoral percutaneous coronary procedures. Two new femoral access site closure devices, Perclose and Angio-Seal , have been proposed as alternative methods to manual compression (MC). We compared these two devices and tested them in reference to standard MC for safety, effectiveness and patient preference.

Methods: Prospective demographic, peri-procedural, and late follow-up data for 1,500 patients undergoing percutaneous coronary procedures were collected from patients receiving femoral artery closure by MC (n = 469), Perclose (n = 492), or Angio-Seal (n = 539). Peri-procedural, post-procedural, and post-hospitalization endpoints were: 1) safety of closure method; 2) efficacy of closure method; and 3) patient satisfaction.

Results: Patients treated with Angio-Seal experienced shorter times to hemostasis (p < 0.0001, diagnostic and interventional) and ambulation (diagnostic, p = 0.05; interventional, p < 0.0001) than those treated with Perclose. Those treated with Perclose experienced greater access site complications (Perclose vs. Angio-Seal, p = 0.008; Perclose vs. MC, p = 0.06). Patients treated with Angio-Seal reported greater overall satisfaction, better wound healing and lower discomfort (each vs. Perclose or vs. MC, all p < or = 0.0001). For diagnostic cath only, median post-procedural length of stay was reduced by Angio-Seal (Angio-Seal vs. MC, p < 0.0001; Angio-Seal vs. Perclose, p = 0.009). No difference was seen in length of stay for interventional cases.

Conclusions: Overall, Angio-Seal performed better than Perclose or MC in reducing time to ambulation and length of stay among patients undergoing diagnostic procedures. There was a higher rate of successful deployment and shorter time to hemostasis for Angio-Seal, and this was accomplished with no increase in bleeding complications throughout the follow-up. Additionally, Angio-Seal performed better than Perclose in exhibiting a superior 30-day patient satisfaction and patient assessment of wound healing with less discomfort.

Publication types

  • Comparative Study

MeSH terms

  • Abciximab
  • Aged
  • Angioplasty, Balloon, Coronary*
  • Antibodies, Monoclonal / therapeutic use
  • Anticoagulants / therapeutic use
  • Coronary Disease / complications
  • Coronary Disease / therapy
  • Female
  • Femoral Artery / surgery*
  • Follow-Up Studies
  • Hemostasis / physiology
  • Hemostatic Techniques / instrumentation
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use
  • Incidence
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Satisfaction
  • Peripheral Vascular Diseases / etiology
  • Peripheral Vascular Diseases / psychology*
  • Peripheral Vascular Diseases / therapy*
  • Postoperative Complications / psychology
  • Postoperative Complications / therapy
  • Predictive Value of Tests
  • Prospective Studies
  • Punctures / instrumentation
  • Punctures / psychology
  • Treatment Outcome


  • Antibodies, Monoclonal
  • Anticoagulants
  • Immunoglobulin Fab Fragments
  • Abciximab