Predictors of complications associated with closure devices after transfemoral percutaneous coronary procedures.

To purchase reprints, contact The InnoVision Group, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 8092273 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, [email protected]. devices approved by the Food and Drug Administration have replaced manual compression and are associated with decreased length of stay and increased comfort and satisfaction for patients. These devices include an implantable collagen plug (VasoSeal, Datascope Corp, Montvale, NJ) and a percutaneous suture device (Perclose, Perclose, Inc, Redwood City, Calif ). Compared with traditional methods used to achieve hemostasis, these closure devices have high overall levels of safety and efficacy. Major complications such as vascular repair surgery, bleeding requiring transfusion, and infection associated with the collagen plug are 2.9%, and the incidence of minor complications, including hematoma, bleeding, and pseudoaneurysm, is 7.2% or less. Complications associated with the percutaneous suture device are 11% or less. Despite these remarkable statistics, identification of risk factors and predictors of complications Jenny B. Hamner, RN, DSN, CCRN E. Jean Dubois, RN, MSN, CRNP Tanya P. Rice, RN, BSN Transfemoral percutaneous coronary procedures have evolved in the past several years as a mainstay in both diagnostic and interventional cardiology. However, safe management of vascular access sites after removal of percutaneous catheters remains a serious concern. Manual compression of the site, the traditional method for closure of the femoral artery, is associated with a complication rate of up to 5%, marked discomfort and immobility for patients, and prolonged hospitalization. New techniques for management of vascular access sites after diagnostic or interventional transfemoral percutaneous coronary procedures have been introduced to increase patients’ comfort and promote a safe recovery. Specifically, new vascular closure ClinicalArticle