Comparison of collagen-based vascular closure devices in patients with vs. without severe peripheral artery disease

J Endovasc Ther. 2014 Feb;21(1):79-84. doi: 10.1583/13-4401MR.1.

Abstract

Purpose: To compare complication rates of a collagen-based vascular closure device (VCD) in patients with vs. without significant peripheral artery disease (PAD).

Methods: A total of 382 patients (268 men; mean age 64.6±10.8 years) undergoing either an endovascular procedure of the lower limb (PAD group, n=132) or a percutaneous coronary intervention (PCI group, n=250) via a common femoral artery access were enrolled in this prospective study if hemostasis was achieved using the collagen-based Angio-Seal. In the PCI group, significant PAD was excluded by measurement of the ankle-brachial index. In-hospital major complications (bleeding, large hematoma, pseudoaneurysm, vessel occlusion, dissection) were recorded.

Results: Similar and low rates of major complications were observed in both arms of the study: 2 (1.5%) major complications in the PAD group and 3 (1.2%) in the PCI group (p=1.0). There was no significant difference in efficacy of the VCDs in the groups (PAD group 99.2% vs. 100% in PCI group, p=0.35).

Conclusion: Our study shows no significant differences in the rate of major complications after utilization of a collagen-based VCD for femoral artery access site closure in patients with severe lower limb PAD compared to those without; however, complications in the PAD group tended to be more severe, with the need for surgical repair.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Collagen / administration & dosage*
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / therapy*
  • Endovascular Procedures / adverse effects*
  • Equipment Design
  • Female
  • Femoral Artery / injuries*
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control*
  • Hemostatic Techniques / instrumentation*
  • Hemostatics / administration & dosage*
  • Humans
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects*
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / therapy*
  • Prospective Studies
  • Punctures
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Vascular System Injuries / diagnosis
  • Vascular System Injuries / etiology
  • Vascular System Injuries / therapy*

Substances

  • Hemostatics
  • Collagen