Postinterventional transcutaneous suture of femoral artery access sites inpatients with peripheral arterial occlusive disease: A study of 930 patients

The purpose of this study was to evaluate a percutaneous vascular suture (P VS) device in patients with peripheral arterial occlusive disease (PAOD) fo r achievement of immediate hemostasis at the vascular access site and early ambulation of fully anticoagulated patients after peripheral interventiona l procedures. From June 1995 to March 2000, a vascular suture using a PVS d evice (6-10 Fr) was applied in 930 patients with PAOD. All patients had rec eived an endoluminal intervention in the pelvic and/or the contralateral fe moropopliteal region via a retrograde access through the common femoral art ery (CFA). The incidence of complications within 12 hr after intervention, prior to discharge, and at 30-day follow-up was assessed employing clinical examination, treadmill test, and color Doppler ultrasound and the safety o f the PVS device was determined, The efficacy of the system was measured by the percentage of achieved immediate hemostasis and early ambulation. PVS was technically successful in 92.2% independently from the degree of calcif ication at the access site. In 7.8%, an appropriate suture delivery could n ot be performed and these patients were successfully treated by conventiona l compression technique. Device malfunction or insufficient suture closure occurred in 1.7% and 2.1%, respectively. In 7.0%, groin-related complicatio ns occurred. Ambulation within 2-4 hr after successful suture was possible in 96.1%. All patients were free of any local symptoms at 30-day follow-up. The PVS device provides a safe and effective solution to achieve immediate hemostasis, thus permitting early ambulation in fully anticoagulated patie nts with PAOD after peripheral interventional procedures. (C) 2001 Wiley-Li ss, Inc.