Arteriotomy Closure Devices for Cardiovascular Procedures

A rterial puncture and sheath insertion by use of the modified Seldinger technique has become the standard method by which invasive cardiovascular procedures are performed.1 With improvement in techniques and devices, a significant number of patients with atherosclerotic disease are undergoing invasive vascular procedures.Approximately 7 million invasive cardiovascular procedures are performed worldwide each year, and this number is expected to increase with the aging of the population.The vast majority of these procedures are performed with femoral arterial access.Because the number of cardiovascular procedures performed via the femoral artery approach continues to increase, effective arterial hemostasis techniques are essential to high-quality patient care.In fact, vascular access complications, reported to be as high as 6% in some series, remain the leading cause of morbidity after a cardiac catheterization procedure.2 Manual compression has been considered the traditional technique to achieve closure of the arteriotomy site, requiring close observation and immobilization for success.Arteriotomy closure devices (ACDs) were introduced in 1995 to decrease vascular complications and reduce the time to hemostasis and ambulation.Subsequently, several generations of passive and active ACDs have been introduced that incorporate suture, collagen plug, nitinol clip, and other mechanisms to achieve hemostasis.According to a new Life Science Intelligence report entitled "2008 Global Vascular Closure Device Markets: US, The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel.Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on July 27, 2010.