Single Perclose VCD in transfemoral TAVI showed similar technical success but reduced major vascular complications by 39%, major bleeding by 72%, and bailout interventions by 55% versus double.
Does a single Perclose VCD strategy improve technical success and reduce complications compared to a double Perclose VCD strategy in patients undergoing transfemoral TAVI?
In patients undergoing transfemoral TAVI, a single Perclose vascular closure device strategy provides comparable technical success to a double Perclose strategy while significantly reducing major vascular and bleeding complications.
Absolute Event Rate: 0% vs 0%
Complications related to vascular closure devices (VCDs) remain relatively common after transcatheter aortic valve implantation (TAVI), while the optimal suture-based strategy remains a subject of debate. This systematic review and meta-analysis aim to evaluate the efficacy and safety of single versus double Perclose VCD in patients undergoing transfemoral TAVI. A literature search was conducted across PubMed, Scopus, and Cochrane databases to identify appropriate studies. The primary outcome was technical success; secondary outcomes included vascular and bleeding complications, bailout interventions, and all-cause mortality. Seven studies (3940 patients) fulfilled the inclusion criteria. Technical success was comparable between the two strategies (relative risk RR: .89; 95% confidence interval CI: .64-1.22), while the single Perclose strategy was associated with a lower risk of major vascular complications (RR: .61; 95% CI: .40-.92), major bleeding (RR: .28; 95% CI: .11-.73) and bailout surgical interventions (RR: .45; 95% CI: .24-.84). There were no differences in minor vascular complications and all-cause mortality. Stepwise closure with the upfront single Perclose strategy demonstrated comparable technical success and a more favorable safety profile regarding major vascular complications and bleeding compared with the double Perclose strategy. Additional randomized controlled trials are essential to validate these findings.
Vythoulkas-Biotis et al. (Wed,) reported a other. Single Perclose VCD in transfemoral TAVI showed similar technical success but reduced major vascular complications by 39%, major bleeding by 72%, and bailout interventions by 55% versus double.