Comparison of Vascular Closure Devices vs Manual Compression After Femoral Artery Puncture

Abstract

Percutaneous coronary angiography and interventions have become a cornerstone in the diagnosis and treatment of coronary artery disease. A substantial proportion of the morbidity associated with these procedures is related to access-site complications.¹ The common femoral artery is still the most frequently used access site, especially in the United States. After the procedure, closure of the arteriotomy site is usually achieved by manual compression.² Since the mid-1990s, however, vascular closure devices (VCDs) have been introduced into clinical practice with the aim of improving efficacy and the safety of percutaneous procedures.³ The devices are implanted to close the arteriotomy of the vessel wall by targeted force. Different types of VCDs have been developed, including intravascular and extravascular devices.¹ Increased efficacy, in comparison with manual compression (ie, reduced time to hemostasis and earlier ambulation), has been a consistent finding across different trials of VCDs.^4,5