Vascular closure devices

Revision as of 21:14, 5 January 2009 by Msf2399 (talk | contribs)
Jump to navigation Jump to search
Vascular closure devices

WikiDoc Resources for Vascular closure devices

Articles

Most recent articles on Vascular closure devices

Most cited articles on Vascular closure devices

Review articles on Vascular closure devices

Articles on Vascular closure devices in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Vascular closure devices

Images of Vascular closure devices

Photos of Vascular closure devices

Podcasts & MP3s on Vascular closure devices

Videos on Vascular closure devices

Evidence Based Medicine

Cochrane Collaboration on Vascular closure devices

Bandolier on Vascular closure devices

TRIP on Vascular closure devices

Clinical Trials

Ongoing Trials on Vascular closure devices at Clinical Trials.gov

Trial results on Vascular closure devices

Clinical Trials on Vascular closure devices at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Vascular closure devices

NICE Guidance on Vascular closure devices

NHS PRODIGY Guidance

FDA on Vascular closure devices

CDC on Vascular closure devices

Books

Books on Vascular closure devices

News

Vascular closure devices in the news

Be alerted to news on Vascular closure devices

News trends on Vascular closure devices

Commentary

Blogs on Vascular closure devices

Definitions

Definitions of Vascular closure devices

Patient Resources / Community

Patient resources on Vascular closure devices

Discussion groups on Vascular closure devices

Patient Handouts on Vascular closure devices

Directions to Hospitals Treating Vascular closure devices

Risk calculators and risk factors for Vascular closure devices

Healthcare Provider Resources

Symptoms of Vascular closure devices

Causes & Risk Factors for Vascular closure devices

Diagnostic studies for Vascular closure devices

Treatment of Vascular closure devices

Continuing Medical Education (CME)

CME Programs on Vascular closure devices

International

Vascular closure devices en Espanol

Vascular closure devices en Francais

Business

Vascular closure devices in the Marketplace

Patents on Vascular closure devices

Experimental / Informatics

List of terms related to Vascular closure devices

Cardiology Network

Discuss Vascular closure devices further in the WikiDoc Cardiology Network
Adult Congenital
Biomarkers
Cardiac Rehabilitation
Congestive Heart Failure
CT Angiography
Echocardiography
Electrophysiology
Cardiology General
Genetics
Health Economics
Hypertension
Interventional Cardiology
MRI
Nuclear Cardiology
Peripheral Arterial Disease
Prevention
Public Policy
Pulmonary Embolism
Stable Angina
Valvular Heart Disease
Vascular Medicine

Editor in Chief: Michael S. Fenster, MD [1]

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Background

At the very heart of any successful endovascular procedure is successful arterial entry and exit. The first successful cardiac catheterization, according to Andre Cournand, was performed on an equine patient in 1844 utilizing a retrograde approach through both the jugular vein and carotid artery1. Human retrograde left heart catheterization was first reported by Zimmerman2 and Limon-Lason3. in 1950. Shortly thereafter in 1953, Seldinger developed the percutaneous technique and this technique was quickly adapted to left heart cardiac catheterizations. With the growth of Interventional Cardiology in the years following Grüntzig’s introduction of coronary angioplasty in 19774 , the percutaneous approach became, and today remains, by far the most common method of performing catheterization, angiography and endovascular intervention. Within the realm of percutaneous approaches, the majority of the procedures are performed from the femoral approach, with a minority being done from a radial approach. Brachial and axillary are also used in a minority of procedures5. Reasons for the continued preference of the femoral route for access includes the vessel size, operator training and equipment, radiation exposure (operator), and the advent of vascular closure devices.

Current Limitations of Vascular Closure Devices

  • Compatible primarily with 5–6 Fr sheath technology
  • Not proven in ≥7Fr technology
  • Require long learning curve
  • Small vessel size (<4.0–5.0mm); a contraindication to use
  • Non-common femoral artery ‘sticks’; a contraindication to use
  • Peripheral vascular disease; a contraindication to use (very common problem)
  • Significant endoluminal device components (prone to thrombosis)
  • High costs
  • Require bed rest post closure
  • Impaired or delayed common femoral artery re-entry (re-access concerns)
  • Non-inert, very reactive, permanent and absorbable device components (therefore may be prone to infection and common femoral artery scarring)
  • Catastrophic complications (1–2%, but may be underreported)
  • Poorly compatible with anticoagulated patients (increased bleeding)

References

1. Cournand, A. (1975). Cardiac Catheterization. Development of the technique and its contribution to experimental medicine, and its initial application in man. Acta Med Scand Suppl , 579:1-32.

2. Zimmerman, H., & Scott, R. B. (1950). Catheterization of the left side of the heart in man. Circulation , 1:357.

3. Limon-Lason, R., & Bouchard, A. (1950). El Caterismo Intracardico; Cateterizacion de la Cavidades Izquierdas en el Hombre. Registro Simultaneo de presion y Electrocardiograma Intracavetarios. Arch Inst Cardiol Mexico , 21:271.

4. Grüntzig, A., et al. (1977). Coronary transluminal angioplasty (abstract). Circulation , 56:II-319.

5.Agostoni, P. et al. (2004). Radial versus femoral apporach for percutaneous coronary diagnostic and interventional procedures-Systematic overview and meta-analysis of randomized trials. J Am Coll Cardiol , 44:349-356.

Template:SIB

Template:WikiDoc Sources