Arterial access site closure with a novel sealing device : Duett

Management of arterial access sites following percutaneous endovascular procedures is associated with patient discomfort and local complications. A new vascular sealing device, comprised of a balloon delivery catheter and a flowable procoagulant consisting of thrombin and collagen, was tested. Immed...

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Bibliographic Details
Published in:Vascular surgery 2001-05, Vol.35 (3), p.199-201
Main Authors: HEYER, Günter, ATZENHOFER, Karl, MEIXL, Herbert, LAMPERSBERGER, Christian, GERSHONY, Gary
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary - instrumentation
Anticoagulants - administration & dosage
Arteries - surgery
Biological and medical sciences
Catheterization - instrumentation
Diseases of the cardiovascular system
Early Ambulation - instrumentation
Equipment Design - instrumentation
Hemostasis, Surgical - instrumentation
Heparin - administration & dosage
Humans
Medical sciences
Middle Aged
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Vascular Diseases - therapy
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Summary:Management of arterial access sites following percutaneous endovascular procedures is associated with patient discomfort and local complications. A new vascular sealing device, comprised of a balloon delivery catheter and a flowable procoagulant consisting of thrombin and collagen, was tested. Immediately following catheterization 200 patients (age, 66.1 +/- 11.2 years) were treated with the sealing device (Duett). Of these 200 patients, 132 underwent diagnostic catheterization, 67 underwent percutaneous transluminal coronary angioplasty, and one underwent percutaneous transluminal angioplasty. The sheath sizes included 2-5 Fr, 166-6 Fr, 25-7 Fr and 7-8 Fr. All patients undergoing diagnostic procedures received at least 5,000 U of intravenous heparin during the procedure. The Duett was used successfully in 198/200 (99%) patients immediately following completion of the endovascular procedure. In two patients a device malfunction resulted in uncomplicated crossover to manual compression. The time to hemostasis ranged from 3 to 5 minutes. All patients were walking 2 to 5 hours following the procedure unless a complication had occurred. No patient experienced leg ischemia, required surgical repair of the arterial access site, or had an infection at the site. In three patients (1.5%), a pseudoaneurysm occurred and was successfully treated with ultrasound-guided compression and three patients received a blood transfusion. No late complications were observed following hospital discharge. This novel vascular sealing device successfully achieves rapid hemostasis and allows early ambulation following percutaneous endovascular procedures with a low incidence of complications.
ISSN:0042-2835