Outcomes after external physical compression versus vascular clouse device use after peripheral vascular intervention via femoral approach

Background: The comparative effectiveness of external physical compression and different vascular closure devices (VCD) in reducing access site complications (ASC) after peripheral vascular interventions (PVI) remains unclear. Methods: We compared short-term outcomes among 57,166 patients in the multicenter, prospective Vascular Quality Initiative Registry who underwent PVI via femoral artery approach between August 2007 and January 2015. Patients were grouped by the access site hemostasis strategies (ASHS) they received (manual compression or VCD), and propensity score matching was used to obtain a balanced cohort of 13,538 patients in each treatment group. Results:ASHS included manual compression (50.8%), suture VCD (9.8%), clip VCD (8.8%), polyethylene glycol collagen plug (CP) VCD (13.3%), sponge CP (9.9%) and other VCD (7.5%). Unadjusted ASC rates were 4.1%, 2.1%, 2.4%, 3.1%, 2.3% and 2.9%, respectively. In the match groups, patients who received VCD had a lower incidence of ASC (2.6% vs 4.41%, p Conclusions: Patients who received VCD after PVI via femoral approach had fewer complications and improved mortality than those who received external physical compression alone. Randomized comparisons of these agents are needed to confirm these findings