Читать книгу Interventional Cardiology - Группа авторов - Страница 55

A variety of vascular closure devices have been developed to enhance vascular closure without need for prolonged compression. These are deployed at the conclusion of the cardiac catheterization procedure and can be used despite an elevated ACT. Closure devices are classified into four major categories: sutures, plugs, glues, and topical patches (Table 2.1). The current FDA‐approved devices in most common use in the USA are the AngioSeal (Terumo), Perclose, ProStar, and StarClose (Abbott Vascular, Redwood City CA). Hemostatic patches are also approved for use in the USA

Table 2.1 Types of closure devices.

	Manufacturer	CE Mark	US Approval	Status
Plugs
AngioSeal	Terumo	+	+
Exoseal	Cordis	+	+	Not used frequently in the USA
Femoseal	Terumo	+	–
Vascade	Cardiva	+	+
Manta	Essential Medical	+	+
Suture devices
ProGlide	Abbott	+	+
ProStar	Abbott	+	+
Staples/clips
StarClose	Abbott	+	+
Angiolink	Medtronic	+	+
Liquid/gel
Duett	Vascular Solutions	+	+
Mynx	Access Closure	+	+
FISH	Morris Innovative	–	+

As a general rule, endorsed by an AHA consensus of experts [25], in all patients considered for a vascular closure device a femoral angiogram should be performed in order to assess the anatomic suitability for its use (puncture site, vessel diameter, atherosclerosis, calcification, etc). The use of vascular closure devices is generally discouraged if the diameter of the common femoral artery is less than 6 mm or if the arterial sheath entry is located below the femoral artery bifurcation or above the inferior hypogastric artery.