Key result
Z-suture shows comparable bleeding rates to ProGlide in left atrial appendage occlusion.
Why the study?
Effective vascular closure after large-bore venous access in patients undergoing LAAO with multiple comorbidities remains a clinical challenge.
Does venous closure with Z-sutures compared to the ProGlide device reduce clinically relevant bleeding in patients undergoing LAA occlusion?
Observational (n=163)
No
Does venous closure with Z-sutures compared to the ProGlide device reduce clinically relevant bleeding in patients undergoing LAA occlusion?
Absolute Event Rate: 12.6% vs 13.5%
Z-sutures offer a safe, effective, and potentially cost-saving alternative to the ProGlide device for venous closure following LAA occlusion.
Comparable bleeding rates despite higher-risk patients in Z-suture group; leaves open whether it offers practical advantages over ProGlide in LAAO.
Background: Left atrial appendage occlusion (LAAO) is a valuable alternative to long-term anticoagulation in patients with atrial fibrillation (AF) and a high bleeding risk. However, effective vascular closure following large-bore venous access remains a clinical challenge, particularly in patients with multiple comorbidities. This study compares two venous closure techniques—Z-sutures and the suture-mediated ProGlide™ device—regarding their safety and efficacy in patients undergoing LAAO. Methods: We conducted a single-center observational study including 163 patients treated with LAAO between 2021 and 2024. Closure was achieved via a Z-suture (n = 126) or the ProGlide™ (n = 37) based on operator preference. The primary endpoint was clinically relevant bleeding (BARC ≥ 2). The secondary endpoints included 30-day mortality and hospital stay duration. Results: The Z-suture group included older and more comorbid patients. Despite these differences, the bleeding rates were comparable between groups. Clinically relevant bleeding was infrequent (Z-suture: 12.6%; ProGlide™: 13.5%). No 30-day deaths occurred in either group, and their hospital stay durations were similar. Conclusions: Both the Z-suture and ProGlide™ techniques demonstrated comparable safety and efficacy. Due to their simplicity and potential cost advantage, Z-sutures may be a practical alternative in routine care for high-risk patients.
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Zako et al. (2025) conducted an observational in Atrial fibrillation undergoing left atrial appendage occlusion (n=163). Z-suture vs. ProGlide device was evaluated on Clinically relevant bleeding (BARC ≥ 2). Z-suture venous closure demonstrated comparable rates of clinically relevant bleeding (12.6%) compared to the ProGlide device (13.5%) in high-risk patients undergoing left atrial appendage occlusion.
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