Does the 'Preclose' technique using two Perclose devices provide effective delayed hemostasis for large-bore (13-14 Fr) sheaths?
The 'Preclose' technique using two Perclose devices offers a feasible strategy for delayed hemostasis of 13-14 Fr sheaths after Impella hemodynamic support.
Advancement of coronary interventions and portable hemodynamic device requires placement of large bore sheaths. Access for large caliber sheaths, its placement, maintenance, and hemostasis is very challenging and one of the key ailments for successful procedures. Traditional hemostasis method is manual compression, which is unattractive due to its own limitations and subsequent complications. Single closure device for sheath size larger than 8 French (Fr) is not available. We performed retrospective analysis of large cohort of patients with 13, 14 Fr sheaths (Impella device ABIOMED) percutaneous closure with the use of two Perclose devices. Two perclose devices were placed in a "Preclose" fashion and hemostasis was obtained few days later once hemodynamic support was weaned off by deployment of perclose sutures.
Lata et al. (Mon,) studied this question.
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