Prospective Nonrandomized Trial of Manual Compression and Angio-Seal and StarClose Arterial Closure Devices in Common Femoral Punctures

Abstract

I read with interest the recent article by Ratnam et al. [1]. There has been a recent surge in the use of closure devices in common femoral artery punctures. The main reasons behind this are early mobility and cost savings [2]. In the article by Ratnam et al., the authors concluded that there was no significant increase in the major complication rate with the use of closure devices. I agree with the authors that statistically there was no difference. However, I would like to highlight the nature and severity of the complications in the group where closure devices were used. The complications in this group included limbthreatening occlusions and life-threatening hematomas. The authors mentioned these complications but failed to stress the point that they were far more severe in the group where closure devices were used. There are many published reports of similar lifeand limb-threatening complications with closure devices [3–7]. I have no doubt that the use of closure devices will increase further, for the reason mentioned above. We should be very careful in deploying these devices, which are probably not justified in all cases. This is also a critical issue for new trainees in interventional radiology and vascular surgery. They should be aware of the potential complications and measures to deal with them [8]. References