Subcutaneous sutures and vascular closure devices achieve immediate hemostasis, facilitate early ambulation, and earlier discharges with fewer venous access site complications compared with manual compression.
Do new approaches to achieving hemostasis (suture techniques, vascular closure devices) improve time to hemostasis and reduce complications compared to manual compression in patients undergoing transvenous procedures for cardiac arrhythmias?
Subcutaneous suture techniques and vascular closure devices are effective alternatives to manual compression for achieving venous hemostasis, offering faster ambulation and reduced complications in patients undergoing transvenous arrhythmia procedures.
Recent decades have seen a series of advances in percutaneous transvenous procedures for cardiac arrhythmias, including the implantation of leadless pacemakers. Many of these procedures require the insertion of large caliber sheaths in large veins, usually the femoral vein. Securing hemostasis efficiently and reliably at the access site is a key step to improving a procedure's safety profile. Traditionally, hemostasis was achieved by manual compression of venous access sites, but the trend toward larger sheaths and the increased use of uninterrupted anticoagulation has pushed the limits of this method. Achieving hemostasis by compression alone in these circumstances requires more attention and longer duration, leading to greater patient discomfort and prolonged immobility. In turn, manual compression may be more time-consuming for medical professionals and increase the number of occupied hospital beds. New approaches have been developed to facilitate early ambulation, decrease patient discomfort, and address the risk of access site complications. These approaches include vascular closure devices and subcutaneous suture techniques including figureof- eight and purse-string sutures. This article reviews the new approaches applied to achieve venous access site hemostasis in patients undergoing transvenous procedures for cardiac arrhythmias.
Waleed et al. (Wed,) conducted a review in Cardiac arrhythmias requiring transvenous procedures. Vascular closure devices and subcutaneous suture techniques vs. Manual compression was evaluated. Subcutaneous sutures and vascular closure devices achieve immediate hemostasis, facilitate early ambulation, and earlier discharges with fewer venous access site complications compared with manual compression.