Comparative Safety of Vascular Closure Devices and Manual Closure Among Patients Having Percutaneous Coronary Intervention

Background: The role of vascular closure devices (VCDs) in patients having percutaneous coronary intervention (PCI) is controversial, and recommendations for use vary. Objective: To examine the use of and outcomes associated with VCDs in real-world practice. Design: Observational cohort study. Setting: 32 hospitals in Michigan that participate in a large multi-center quality improvement collaborative. Patients: Consecutive patients having emergent and nonemergent PCI from 2007 to 2009. Measurements: Vascular complications and the need for transfusion. Results: Of the 85 048 PCIs performed during the study that met the inclusion criteria, 28 528 (37%) procedures used VCDs. In propensity score–matched analysis, VCDs were associated with re