Key result
In patients undergoing TAVI, combination suture-plug vascular closure devices significantly reduced VCD failure compared to suture-only devices (RR 0.14; 95% CI 0.09-0.23; p<0.0001).
Why the study?
Vascular complications after TAVI are common and serious, but the comparative safety and efficacy of suture-collagen plug VCDs versus suture-only devices needed evaluation.
Does the combination of suture-collagen plug vascular closure devices reduce vascular complications and device failure compared to suture-only devices in patients undergoing TAVI?
Meta-Analysis (n=2,064)
Does the combination of suture-collagen plug vascular closure devices reduce vascular complications and device failure compared to suture-only devices in patients undergoing TAVI?
Relative Risk: 0.14 (95% CI 0.09–0.23)
p-value: p=<0.0001
In patients undergoing TAVI, a combination strategy of suture-plug vascular closure devices is superior to suture-only devices in reducing vascular complications, bleeding, and device failure.
Supports combined suture-plug VCD use in TAVI to minimize access complications; extends meta-analytic evidence beyond single-device trials.
Background Transcatheter aortic valve implantation (TAVI) is an effective and safe intervention for severe symptomatic aortic stenosis regardless of surgical risk. Vascular complications following TAVI are considered among the most common and serious complications, with a higher risk of mortality. Aims We aimed to perform a systematic review and meta‐analysis to evaluate the safety and efficacy of the combination of suture‐collagen plug vascular closure devices (VCDs) compared with suture‐only devices. Methods We have systematically searched the literature from inception until January 4, 2025, for cohort studies and clinical trials comparing the combination of suture‐collagen plug vascular closure devices (VCDs) versus suture‐only VCDs. Results A total of 2064 patients across six studies were included in the analysis. All studies compared dual Perclose ProGlide versus 1 Perclose ProGlide + 1 Angio‐Seal, except one study that used either one Prostar or dual ProGlide in the suture group. The combination group of suture‐plug VCDs was associated with a statistically significant reduction of VCDs failure (RR = 0.14, CI 95% [0.09–0.23], p < 0.0001, I 2 = 58.6938%), bleeding complications (RR = 0.35, CI95% [0.24–0.53], p < 0.0001, 0.0%), major vascular complications (RR = 0.42, CI 95% [0.28, 0.63], p < 0.0001, I 2 = 50.4%), and minor vascular complications (RR = 0.54, CI 95% [0.43, 0.66], p < 0.0001, I 2 = 0%). On the other hand, all‐cause mortality did not have a statistically significant difference between the two groups (RR = 0.54, CI 95% [0.28, 1.05], p = 0.0709, I 2 = 0%). Conclusions In patients undergoing TAVI, the combination strategy of suture‐plug VCDs is superior to suture‐only devices regarding major and minor vascular complications, bleeding complications, and VCD failure. The significantly higher VCD failure of the suture‐only group observed in our study led to the use of additional closure devices to secure hemostasis, raising concerns about a higher risk of peripheral ischemia.
No takes yet. Share an insight, caveat, or question.
Haddad et al. (2025) conducted a meta-analysis in Severe symptomatic aortic stenosis (n=2,064). Combination of suture-collagen plug vascular closure devices vs. Suture-only vascular closure devices was evaluated on Vascular closure device (VCD) failure (RR 0.14, 95% CI 0.09-0.23, p=<0.0001). In patients undergoing TAVI, combination suture-plug vascular closure devices significantly reduced VCD failure compared to suture-only devices (RR 0.14; 95% CI 0.09-0.23; p<0.0001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: