Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Sep 28, 2018; 10(9): 108-115
Published online Sep 28, 2018. doi: 10.4329/wjr.v10.i9.108
Korean single-center experience with femoral access closure using the ExoSeal device
Yoonhee Han, Jae Hyun Kwon, Surin Park
Yoonhee Han, Jae Hyun Kwon, Surin Park, Department of Radiology, Dongguk University Ilsan Hospital, Goyang-si 10326, Gyeonggi-do, South Korea
Author contributions: Han Y performed the clinical procedures, data analysis and manuscript writing; Kwon JH performed the clinical procedures and data analysis; Park S performed the data analysis and manuscript writing.
Institutional review board statement: This study was reviewed and approved by the Dongguk University Ilsan Hospital Institutional Review Board (approval No. DUIH 2017-10-003-001).
Informed consent statement: The study investigators obtained informed consent from all included patients, and the study was conducted in accordance with the principles of the Helsinki Declaration.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yoonhee Han, MD, PhD, Associate Professor, Department of Radiology, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Siksa-dong, Ilsandong-gu, Goyang-si 10326, Gyeonggi-do, South Korea. hanyoonhee@naver.com
Telephone: +82-10-52729747 Fax: +82-31-9618281
Received: April 27, 2018
Peer-review started: April 27, 2018
First decision: June 14, 2018
Revised: August 6, 2018
Accepted: August 23, 2018
Article in press: August 24, 2018
Published online: September 28, 2018
Abstract
AIM

To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using ExoSeal vascular closure devices (VCDs).

METHODS

Between November 2015 and April 2017, we performed 179 diagnostic and interventional angiographic procedures via a common femoral arterial access. The ExoSeal VCD was used at the puncture site to achieve hemostasis in 125 patients. We evaluated the technical and procedural success rates, the complications, and the factors affecting the hemostasis time of the ExoSeal VCDs.

RESULTS

Technical and procedural successes were achieved in 176 cases (98.0%) and 128 cases (71.5%), respectively. Device failure occurred in 3 (1.7%) cases. In 1 case (0.6%) a small hematoma developed, but there were no major complications. Among the hemostasis-relevant variables, a history of drinking alcohol, low platelet (PLT) count, and high prothrombin time-international normalized ratio (commonly known as PT-INR) values were the statistically significant predictors of the need for longer manual compression (MC). There was no difference in the success rates between the repeat and single ExoSeal procedure groups, and repeated use of the ExoSeal did not affect hemostasis time.

CONCLUSION

The ExoSeal VCD effectively achieves hemostasis, with few complications. Longer light MC may be needed with alcohol drinkers, low PLT count, and high PT-INR values.

Keywords: Vascular closure device, Femoral access, Manual compression, Angiography, Hemostasis

Core tip: This study aimed to report the experience of closure of the femoral artery over a 17-mo period using ExoSeal vascular closure devices (VCDs). Technical and procedural successes were achieved in 176 cases (98.0%) and 128 cases (71.5%), respectively, while device failure occurred in only 3 (1.7%) cases. Repeated use of the ExoSeal did not affect hemostasis time or success rate. Thus, ExoSeal VCD is a simple, safe and effective device for achieving hemostasis with few complications. However, longer light manual compression may be needed with alcohol drinkers, low platelet counts, and high prothrombin time-international normalized ratio values.