Comparison of costs and safety of a suture-mediated closure device with conventional manual compression after coronary artery interventions

The aim of this study was to assess costs and safety of immediate femoral sheath removal and closure with a suture‐mediated closure device (Perclose, Menlo Park, CA) in patients undergoing elective (PCI). A total of 193 patients was prospectively randomized to immediate arterial sheath removal and a...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2002-11, Vol.57 (3), p.297-302
Main Authors: Rickli, Hans, Unterweger, Martin, Sütsch, Gabor, Brunner-La Rocca, Hans Peter, Sagmeister, Markus, Ammann, Peter, Amann, Franz W.
Format: Article
Language:English
Subjects:
access site
Aged
Angioplasty, Balloon, Coronary - economics
Angioplasty, Balloon, Coronary - instrumentation
arterial puncture site
Bandages - economics
cardiac catheterization
Coronary Artery Disease - complications
Coronary Artery Disease - economics
Coronary Artery Disease - therapy
costs
Costs and Cost Analysis
Early Ambulation
Equipment Safety - economics
Female
Follow-Up Studies
Hemoglobins - metabolism
Hemostasis, Surgical - economics
Hemostasis, Surgical - instrumentation
Humans
Male
Middle Aged
Postoperative Complications - economics
Postoperative Complications - etiology
Prospective Studies
Suture Techniques - economics
Suture Techniques - instrumentation
Treatment Outcome
vascular closure device
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Summary:The aim of this study was to assess costs and safety of immediate femoral sheath removal and closure with a suture‐mediated closure device (Perclose, Menlo Park, CA) in patients undergoing elective (PCI). A total of 193 patients was prospectively randomized to immediate arterial sheath removal and access site closure with a suture‐mediated closure device (SMC; n = 96) or sheath removal 4 hr after PCI followed by manual compression (MC; n = 97). In the SMC group, patients were ambulated 4 hr after elective PCI if hemostasis was achieved. In the MC group, patients were ambulated the day after the procedure. In addition to safety, total direct costs including physician and nursing time, infrastructure, and the device were assessed in both groups. Total direct costs were significantly (all P < 0.001) lower in the SMC group. Successful hemostasis without major complication was achieved in all patients. The time to achieve hemostasis was significantly shorter in the SMC group (7.1 ± 3.4 vs. 22.9 ± 14.0 min; P < 0.01) and 85% of SMC patients were ambulated on the day of intervention. Suture‐mediated closure allows a reduction in hospitalization time, leading to significant cost savings due to decreased personnel and infrastructural demands. In addition, the use of SMC is safe and convenient to the patients. Cathet Cardiovasc Intervent 2002;57:297–302. © 2002 Wiley‐Liss, Inc.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.10294