Vascular closure devices (VCDs) significantly reduce complications and bleeding in appropriate patients undergoing percutaneous coronary intervention (PCI), according to an article published in Annals of Internal Medicine.
VCDs permit closure of the access site using sutures, plugs, or metallic clips, especially after PCI by transfemoral route. VCDs are commonly used in clinical practice, yet there is little data on their efficacy for decreasing vascular complications.
Researchers studied a large number of patients undergoing transfemoral PCI at 32 Michigan hospitals to assess the association of VCDs with vascular complications. The researchers specifically focused on patient subgroups that may be at particularly high risk for these complications, but in whom data have been lacking. They found that VCDs were associated with a significant reduction in the odds of vascular complications and blood transfusions for all patients except for those with a body mass index of less than 25 kg/m2 and those who received a platelet GP IIb/IIIa inhibitor. In those patients, there was no benefit to using VCDs. These findings should help guide physicians and patients in choosing between manual closure and VCDs in transfemoral PCI.