Vascular Closure Devices in Interventional Radiology Practice. 2015

Rafiuddin Patel, and Stefan Muller-Hulsbeck, and Robert Morgan, and Raman Uberoi
Department of Radiology, John Radcliffe Hospital, Oxford, UK, rafiuddin.patel@ouh.nhs.uk.

Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

UI MeSH Term Description Entries
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D006487 Hemostasis The process which spontaneously arrests the flow of BLOOD from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements (eg. ERYTHROCYTE AGGREGATION), and the process of BLOOD COAGULATION. Hemostases
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015642 Radiology, Interventional Subspecialty of radiology that combines organ system radiography, catheter techniques and sectional imaging. Interventional Radiology
D065506 Vascular Closure Devices Products used to seal the openings in BLOOD VESSELS from incisions or punctures made during ENDOVASCULAR PROCEDURES. Catheterization Closure Devices,Vascular Closure Patches,Catheterization Closure Device,Closure Device, Catheterization,Closure Device, Vascular,Closure Devices, Catheterization,Closure Devices, Vascular,Closure Patches, Vascular,Device, Catheterization Closure,Device, Vascular Closure,Devices, Catheterization Closure,Devices, Vascular Closure,Patches, Vascular Closure,Vascular Closure Device

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