Percutaneous Femoral Access and Vascular Closure Devices

Percutaneous femoral access for cardiac catheterization has become one of the most widely utilized procedures in the United States. Still, the rate of complications with vascular access and closure remains high. Vascular closure devices have undergone scrutiny since their debut in the early 1990s, but are considered to be a safe and efficacious alternative to manual compression in certain circumstances. In particular, they provide improved patient comfort and decreased time to ambulation and hospital discharge. Newer devices may expand the population in which devices can be used to include those currently considered high risk, such as patients with small caliber vessels and peripheral arterial disease. The following chapter begins with a strategic approach to vascular access in attempts to minimize patient risk, and then gives a review of the major vascular closure devices, with an emphasis on emerging studies and their future role in arteriotomy closure