Abstract
Background
Percutaneous arterial closure devices have increasingly entered clinical practice to assist in achieving femoral arterial access site hemostasis. Prior studies have demonstrated the safety and efficacy of several arterial closure devices in adults.
Objective
To evaluate the efficacy of using an arterial closure device in children.
Materials and methods
A retrospective review of all children (defined as younger than 18 years) undergoing device-assisted closure of their percutaneous femoral arterial access site was conducted. Patient demographics, the clinical indications for use of the arterial closure device and pre-procedural laboratory parameters were noted. The accessed common femoral artery diameter and largest procedural sheath size were recorded. The technical success rate for device deployment and rates of immediate and delayed complications including hemorrhage, access site or retroperitoneal hematoma, access site infection, arterial thromboembolism, pseudoaneurysm or arteriovenous fistulae were documented.
Results
Between June 2009 and June 2011, an arterial closure device was deployed with intent to achieve hemostasis in percutaneous femoral arterial access punctures in 38 consecutive children. The mean common femoral artery diameter was 0.70 ± 0.13 cm. Device deployment was technically successful in 37/38 (97.4%) procedures. There was a single complication (2.6%), a small access site hematoma. No other immediate or delayed complications occurred.
Conclusion
The use of a percutaneous arterial closure device can be an efficacious method for achieving immediate femoral arterial access site hemostasis with few complications in children who have undergone percutaneous femoral arterial access procedures.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Das R, Ahmed K, Athanasiou T et al (2011) Arterial closure devices versus manual compression for femoral haemostasis in interventional radiological procedures: a systematic review and meta-analysis. Cardiovasc Intervent Radiol 34:723–738
Deuling JH, Jaarsma T, Vermeulen RP et al (2008) A randomized control trial comparing StarClose and AngioSeal vascular closure devices in a district general hospital. Int J Clin Pract 62:1801
Hoffer EK, Bloch RD (2003) Percutaneous arterial closure devices. J Vasc Interv Radiol 14:865–885
Koreny M, Riedmuller E, Nikfardjam M et al (2004) Arterial puncture closing devices compared with standard manual compression after cardiac catheterization: systematic review and meta-analysis. J Am Med Assoc 291:350–357
Semler HJ (1985) Transfemoral catheterization: mechanical versus manual control of bleeding. Radiology 154:234–235
Prayck JB, Wall TC, Longabaugh P et al (1998) A randomized trial of vascular hemostasis techniques to reduce femoral vascular complications after coronary intervention. Am J Cardiol 81:970–976
Keeling A, Taylor V, Nordt LA et al (1996) Reducing time in bed after cardiac catheterization (TIBS II). Am J Crit Care 5:277–281
McCabe PJ, McPherson LA, Lohse CM et al (2001) Evaluation of nursing care after diagnostic coronary angiography. Am J Crit Care 10:330–340
Tron C, Koning R, Eltchaninoff H et al (2003) A randomized comparison of a percutaneous suture device versus manual compression for femoral artery hemostasis after PTCA. J Interv Cardiol 16:217–221
Upponi SS, Ganeshan AG, Warakaulle DR et al (2007) Angioseal versus manual compression for haemostasis following peripheral vascular diagnostic and interventional procedures—a randomized controlled trial. Eur J Radiol 61:332–334
Martin JL, Pratsos A, Magargee E et al (2008) A randomized trial comparing compression, Perclose Proglide and Angio-Seal VIP for arterial closure following percutaneous coronary intervention: the CAP trial. Catheter Cardiovasc Interv 71:1–5
Rodriguez A, Katz SG (2011) The use of Starclose device for obtaining femoral artery hemostasis. Vasc Endovasc Surg 45:627–630
Azmoon S, Pucillo AL, Aronow WS et al (2010) Vascular complications after percutaneous coronary intervention following hemostasis with the Mynx vascular closure device versus the AngioSeal vascular closure device. J Invasive Cardiol 22:179–180
St. Jude Medical (2007) Angio-Seal™ Evolution [Instructions for use]. St. Jude Medical, Minnetonka
Altin RS, Flicker S, Naidech HJ (1989) Pseudoaneurysm and arteriovenous fistula after femoral artery catheterization: association with low femoral puncture. AJR Am J Roentgenol 152:629–631
Heintzen MP, Straure BE (1998) [Peripheral arterial complications after heart catheterization]. Herz 23:4–20
Iqtidar AF, Li D, Mather J et al (2011) Propensity matched analysis of bleeding and vascular complications associated with vascular closure devices vs. standard manual compression following percutaneous coronary intervention. Conn Med 75:5–10
Schwartz BG, Burstein S, Economides C et al (2010) Review of vascular closure devices. J Invasive Cardiol 22:599–607
Taylor LM Jr, Troutman R, Feliciano R et al (1990) Late complications after femoral artery catheterization in children less than five years of age. J Vasc Surg 11:297–304
Lee HY, Reddy SC, Rao PS (1997) Evaluation of superficial femoral artery compromise and limb growth retardation after transfemoral artery balloon dilatations. Circulation 95:974–980
Applegate RJ, Grabarczyk MA, Little WC et al (2002) Vascular closure devices in patients treated with anticoagulation and IIb/IIIa receptor inhibitors during percutaneous revascularization. J Am Coll Cardiol 40:78–83
Conflicts of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Prabhu, S.J., Padia, S.A., Valji, K. et al. Arterial closure device to achieve hemostasis in children following percutaneous femoral arterial puncture. Pediatr Radiol 43, 703–708 (2013). https://doi.org/10.1007/s00247-012-2606-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-012-2606-9