부산대학교 도서관

Background: The failure rate of vascular closure devices remains a significant cause of major vascular complications in contemporary transcatheter aortic valve implantation practice. Methods: This research aimed to evaluate use of the Angio-Seal device in a bailout context in the setting of incomplete hemostasis following use of dual Perclose ProGlide devices in patients undergoing transfemoral transcatheter aortic valve implantation. A total of 185 patients undergoing transfemoral transcatheter aortic valve implantation with either dual Perclose ProGlide (n=139) or a combination of dual Perclose ProGlide and Angio-Seal (n=46) were retrospectively analyzed. The baseline, procedural characteristics, and all outcomes (defined according to Valve Academic Research Consortium-2 criteria) were compared. Results: No significant differences were seen between the dual Perclose ProGlide vs dual Perclose ProGlide+Angio-Seal groups with regard to the in-hospital Valve Academic Research Consortium-2 primary end points of major vascular complications (n=13 [9.4%] vs n=2 [4.3%]; P=.36), minor vascular complications (n=13 [9.4%] vs n=8 [14.7%]; P=.14), major bleeding (n=16 [11.5%] vs n=2 [4.3%]; P=.25), and minor bleeding (n = 9 [6.5%] vs n = 5 [10.9%]; P=.34), with higher rates of hematoma in the dual Perclose ProGlide+AngioSeal group (n=4 [2.9%] vs n=5 [10.9%]; P=.044). Conclusion: Finding from the current study suggest that adjunctive Angio-Seal deployment may be feasible and safe, especially in patients with incomplete hemostasis following dual Perclose ProGlide use, and can be an optimal “bailout” procedure. [ABSTRACT FROM AUTHOR]