Comparison of femoral closure devices with manual compression in postcardiac catheterization patients

Abstract

The objective of our study was to compare femoral closure devices to manual compression in limiting vascular access complications at our center. Data was obtained from computer database for cardiac catheterizations done at University of Florida, Jacksonville from 1st March 2002 to 29th February 2004. Vascular complications included groin bleeding, hematoma (> 4 cm), retroperitoneal bleeding, AV fistula, limb ischemia , pseudoaneurysm, infection and death as a direct result of vascular complication. Hemostasis technique was divided into three groups; Manual compression, Sealant and Suture group. A total number of 3843 cases were performed and all variables were similarly distributed among three groups except for lesser GpIIb/IIIa inhibitor use in sealant group. A total of 71 complications (1.85%) were recorded. They included 33 bleeds, 12 Pseudoaneurysms, 17 hematomas (> 4 cm), 4 retroperitoneal bleeds, 2 AV fistulae, 1 infection and 2 deaths. Overall, 9 complications occurred in Sealant group (0.85%), 4 in Suture group (3.3%) and 58 (2.1%) in manual compression. Logistic regression analysis showed that when GpIIb/IIIa agents are not used, Sealant device is associated with less vascular complications. (p = 0.008) However, with GpIIb/IIIa agents there is no difference among closure devices or manual compression (p = 0.074) with overall increase in vascular complications. Sealant closure devices are associated with less vascular complications at our center when GpIIb/IIIa agents were not used. However, with GPIIb/IIIa inhibitors , there is no difference in the vascular complications among the three groups.