Venous vascular access with sheath size up to 14 Fr is not uncommon in interventional electrophysiology and cardiology. Often, even double access is necessary. In contrast to arterial vascular access, where a variety of closure devices are available, no such devices exist for closure after venous puncture. The Figure-of-8-Suture, an easy to apply suture, may be a feasible approach for closure venous puncture. Our aim was to evaluate the feasibility of closure of femoral venous access.
Methods
From January to October 2017, patients undergoing electrophysiological procedures, closure of left atrial appendage or patent foramen ovale were included. Until May 2017, manual compression was performed to achieve haemostasis at the venous access site (control group). From May 2017, patients were treated with a Figure-of-8-Suture (treatment group, Figure 1). Turnover time and incidence of vascular complications were compared between the two groups.
Results
In the study period, 154 patients were included, 56 in the control group and 98 in the treatment group (Table 1). There were significantly fewer vascular complications in the group of patients treated with the Figure-of-8-Suture compared to the conventional manual compression (1% vs. 7.1%, p=0.039, Table 2). Turnover time was not significantly different between the groups. Yet, a trend towards a shorter turnover time in the treatment group was observed (Table 2).
Conclusion
Our results show a significantly lower incidence of vascular complications in patients treated with a Figure-of-8-Suture after venous access with large sheaths. Turnover time trended to be shorter. Figure-of-8-Suture may therefore be feasible to achieve haemostasis after femoral venous access in interventional electrophysiology and cardiology.
Figure 1: Principle of the Figure-of-8-Suture
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