A Novel Technique for Augmented Hemostasis After Perclose Deployment: Tamponade on Perclose-Hemostasis Augmentation Technique (TOP-HAT)

Catheter Cardiovasc Interv. 2026 Mar;107(4):955-959. doi: 10.1002/ccd.70409. Epub 2025 Dec 15.

Abstract

Background: With the advent of advanced structural procedures and circulatory devices, large-bore access has become increasingly common. However, vascular access site complications present serious prognostic risks. While suture-based and collagen-based devices have been described for vascular closure, these techniques require maintenance of wire access.

Aims and methods: We present a novel technique for achieving hemostasis once wire access has been lost and the perclose (standard suture-based device) has been deployed, utilizing a collagen plug; Tamponade On Perclose; Hemostasis Augmentation Technique (TOPHAT).

Results and conclusion: We have utilized this technique at a single center with multiple users at different levels of expertise without any complications to date.

MeSH terms

  • Cardiac Catheterization* / adverse effects
  • Cardiac Catheterization* / instrumentation
  • Catheterization, Peripheral* / adverse effects
  • Catheterization, Peripheral* / instrumentation
  • Collagen* / administration & dosage
  • Equipment Design
  • Female
  • Hemorrhage* / etiology
  • Hemorrhage* / prevention & control
  • Hemostasis
  • Hemostatic Techniques* / adverse effects
  • Hemostatic Techniques* / instrumentation
  • Humans
  • Male
  • Middle Aged
  • Punctures
  • Treatment Outcome

Substances

  • Collagen