Usefulness of an access-site hemostasis device in neuroendovascular treatment

Background We examined the safety and efficacy of the access-site hemostasis device Angio-Seal™ STS Plus (AS; St. Jude Medical,St. Paul, MN, USA) compared with the method of hemostasis by manual compression (MC) in neuroendovascular therapy. Method We conducted a prospective multicenter registration...

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Published in:	Acta neurochirurgica Vol. 159; no. 12; pp. 2331 - 2335
Main Authors:	Sato, Masayuki, Matsumaru, Yuji, Sakai, Nobuyuki, Imamura, Hirotoshi, Hirohata, Masaru, Takeuchi, Yasuharu, Matsumato, Yasushi, Suzuki, Ichirou
Format:	Journal Article
Language:	English
Published:	Vienna Springer Vienna 01-12-2017 Springer Nature B.V
Subjects:	Aged Cardiovascular system Compression Endovascular Procedures - instrumentation Female Femoral Artery Hematoma Hematoma - etiology Hemostasis Hemostatic Techniques - instrumentation Hemostatics Humans Interventional Radiology Length of Stay Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Original Article - Vascular Prospective Studies Punctures - adverse effects Surgical Orthopedics Access site complication Angio-Seal Neuroendovascular therapy Manual compression
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Summary:	Background We examined the safety and efficacy of the access-site hemostasis device Angio-Seal™ STS Plus (AS; St. Jude Medical,St. Paul, MN, USA) compared with the method of hemostasis by manual compression (MC) in neuroendovascular therapy. Method We conducted a prospective multicenter registration study enrolling 229 patients who were scheduled to undergo endovascular treatment. Results Of the 119 and 110 cases assigned to the AS and MC groups, 118 (99.2%) and 105 (95.5%) achieved successful hemostasis, respectively. Six AS patients and 38 MC patients had access-site hematoma (5% vs 34.5%, P < 0.001). Hemostasis time was significantly shorter in the AS group than in the MC group (4.4 min vs 150.7 min, P < 0.001). Puncture-site hematoma was significantly larger in the AS group than the MC group (5.5 cm vs 2.9 cm, P < 0.05). Patients in the AS group had a significantly shorter hospital stay than those in the MC group (8.7 days vs 13.3 days, P < 0.001); they also had a significantly shorter time before they could start to walk (23.9 h vs 52.2 h, P < 0.001). No serious adverse events were noted in either group. Minor adverse events included four cases from the AS group and two cases from the MC group. Conclusions Use of an access-site hemostatic device resulted in quick and reliable access-site hemostasis in neuroendovascular therapy. When using AS, it is necessary to be careful when there is a possibility of a hematoma, as the hematomas, though significantly less frequent than in MC, were significantly bigger in that group.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0001-6268 0942-0940
DOI:	10.1007/s00701-017-3299-5