Comparative analysis of vascular closure devices for neuroendovascular procedures using Perclose versus Angioseal.

Abstract

Background: The common femoral artery is most frequently accessed for neuroendovascular procedures. Occasionally, postoperative hemostasis is difficult to attain. We comparatively analyzed the vascular closure devices, Angioseal and Perclose, and evaluated the puncture-site complications.

Methods: 357 patients who underwent endovascular treatment via femoral artery puncture and achieved hemostasis using a device were included. We studied the hemostatic method and associated puncture-site complications for various conditions. Ordinal logistic multiple regression analysis was performed for age, sex, sheath diameter, hemostatic method, number of antiplatelet agents, and object disease to identify the factors associated with puncture-site complications.

Results: Angioseal was used in 233 cases, and Perclose in 124 cases. Non-surgical complications were observed in 7.3 % and 0.8 % patients respectively. Complications requiring surgery occurred in 0.9 % of Angioseal, while none of Perclose. The complication rate at the puncture site was 10 % for unruptured aneurysms, 2.3 % for ruptured aneurysms, 3.5 % for carotid artery stenosis, and 4.0 % for acute arterial occlusive disease. Complication-related factors (P < 0.05) were fewer for Perclose (P = 0.0013,OR = 0.09) and higher for unruptured aneurysms (P = 0.0085, OR = 3.62).

Conclusions: Perclose is a vascular closure device with rare puncture-site complications for neurosurgical diseases. Unruptured aneurysm cases require careful attention to puncture-site complications.