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Vascular Closure Devices

Vascular closure devices (VCDs) are being increasingly used in patients undergoing cardiac catheterization via femoral route. They offer several benefits including reduced time to hemostasis and early patient mobilization. There are few relative contraindications to the use of VCDs:re devices.

  1. Low femoral arterial cannulation (bifurcation/superficial femoral artery/profunda femoris): increased risk of ischemic complications
  2. Small femoral arterial caliber (<4-5 mm): increased risk of ischemic complications particularly with intravascular device, Angioseal
  3. Peripheral arterial disease (moderate to severe) at site of cannulation: increased risk of complications with intravascular VCDs
There are two main different types available – Intravascular and Extravascular closure devices.

Intravascular Closure Devices

Perclose (Abbott)

  • Perclose device is based on percutaneous delivery of polypropylene monofilament suture to the access site
  • Consists of delivery device (with biodegradable, pretied suture), snared knot pusher and suture trimmer
  • Advantage of maintaining guidewire re-access
  • Broadest indication: 5-21 F arterial sheaths and 5-24 F venous sheaths

Angioseal (Terumo)

  • Based on a mechanical seal created by sandwiching the arteriotomy between a bioabsorbable anchor and collagen sponge, which dissolve in 60-90 days
  • Consists of an anchor (intravascular footplate), collagen and polyglycolic acid suture
  • Available in 6 and 8 F platforms

Menta (Teleflex)

  • Designed specifically for large bore femoral arterial access site closure
  • A single MANTA Device effectively closes femoral arterial access sites following the use of sheaths ranging from 12 Fr to 25 Fr O.D.
  • Available in 14 Fr and 18 Fr

Extravascular Devices

Vascade (Cardiva Medical, Inc.)

  • Extravascular closure system with bioabsorbable thrombogenic collagen patch
  • Collapsible disc design allows insertion through procedural sheath and release of pre-loaded collagen patch
  • Approved for 5-7 F arterial and venous closure

Mynx (Cordis)

  • Extravascular closure device with resorbable non-thrombogenic MynxGrip sealant
  • Sealant consists of water-soluble polyethylene glycol polymer which adheres to the arteriotomy site and quickly absorbs blood
  • Indicated for 5-7 F arterial closure
Case ExamplesEducational Content

ATHERECTOMY COMPLICATIONS

Case ExamplesEducational Content

BYPASS GRAFT COMPLICATIONS

ModelBurst (ATM)Diameter (mm)Balloon Length (mm)              
681215202530
MINI TREK (CTO INDICATED)1.271.2
1.561.5
2.172✓*✓*
TREK2.372.25
2.672.5
2.912.75
3.113
3.53.25
3.73.5
3.943.75
4.324
4.864.5
5.365
*Only available as RX, not as OTW. Other sizes available in both versions.
Retrieved on April 07 2022 from Abbott product ordering information. Please look at the company's files for the latest available data on device configurations and avilability in your area.

Left Main DK Crush Video ID