Percutaneous vascular closure using an anchored collagen plug provides effective haemostasis following both antegrade and retrograde femoral arterial punctures.
OBJECTIVES
Small published series suggest a higher failure rate for Angio-Seal vascular closure device (VCD) deployment after antegrade femoral puncture, despite the need for shorter haemostasis times, early discharge, and possibly higher turnover. We seek to compare the deployment efficacy and complications of the Angio-Seal VCD between antegrade and retrograde femoral arterial deployments.


METHODS
Radiological data was retrospectively analysed from prospective databases from the hospitals' Computerised Radiology Information System (CRIS) over 2010-2012. Angio-Seal gauge, Rutherford class (as applicable), puncture mode (used to classify deployment as antegrade/retrograde), sheath sizes, and deployment success/failures were recorded. Numerical/statistical analyses were undertaken using Microsoft Excel 10/SISA software.


RESULTS
A total of 519 Angio-Seal VIP VCDs were deployed in 470 patients over 2010-2012 (13 other patients could not be analysed due to incomplete data). Sheath sizes for antegrade/retrograde femoral puncture were 5F, n = 22/9; 6F, n = 244/223; 7F, n = 1/5; 9F, n = 4/0. 8F Angio-Seal VIPs were used for 9F punctures only, 6F for the remainder. The overall deployment success rate was 93.7%. In total, 247 (91.1%) successful antegrade deployments were undertaken with 24 (8.9%) failures, compared with 229 (96.6%) successful retrograde deployments with eight (3.4%) failures. Antegrade/retrograde failures were classed as failure to deploy, n = 15/5; bleeding despite successful deployment requiring supplementary compression, n = 6/1; haematoma formation, n = 2/1; groin pain, n = 0/1; vessel stenosis, n = 1/0. Higher deployment failures were noted with antegrade deployment (p < .02, chi-square test).


CONCLUSIONS
Angio-Seal deployment is successful for both antegrade/retrograde femoral punctures albeit with a higher antegrade failure rate.
['Chaudhuri|A|A|', 'York|A|A|', 'Dey|R|R|']
D000368:Aged D000369:Aged, 80 and over D002406:Catheterization, Peripheral D016009:Chi-Square Distribution D003094:Collagen D005260:Female D005263:Femoral Artery D006489:Hemostatic Techniques D006490:Hemostatics D006801:Humans D008297:Male D008875:Middle Aged D011677:Punctures D011873:Radiology Information Systems D012189:Retrospective Studies D012307:Risk Factors D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
Femoral artery puncture Angio-Seal Vascular closure device Angiography/angioplasty Hemostasis