Outcomes of single versus double Perclose suture device use after transfemoral transcatheter procedures using large-bore arterial access: A meta-analysis and systematic review.

IF 2.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine Pub Date : 2026-08-21 DOI:10.1016/j.carrev.2026.08.012

Priyesh Thakurathi, JuYong Lee, Michael G Nana, Shrija Thapa, Rupesh Kshetri, Agnes S Kim, Raymond G McKay, Khagendra Dahal

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引用次数: 0

Abstract

Background: In large-bore transfemoral procedures such as transcatheter aortic valve replacement and endovascular aneurysm repair, the comparative effectiveness of single (SP) versus the default double Perclose (DP) strategies for arterial closure remains uncertain.

Methods: We performed a systematic literature search in PubMed, Scopus, Web of Science, and the Cochrane Library from January 2014 to April 2026 to identify studies comparing SP and DP devices for large-bore transfemoral arterial access closure. Outcomes included device/technical success, need for unplanned surgical or catheter-based intervention, 30-day mortality, any vascular complication, major bleeding, arterial dissection, and arterial stenosis. Random-effects meta-analysis using inverse-variance weighting was performed, and heterogeneity was assessed using the I² statistic.

Results: We identified 14 studies published or available between 2015 and 2026, comprising 6487 patients before matching or adjustment (SP 3518; DP 2969). Post-matching adjusted cohorts comprised 5077 patients (SP 2691; DP 2386). Comparing SP with DP, device/technical success was similar (RR 1.02, 95% CI 1.00-1.03; P = 0.07), as was the need for unplanned surgical/catheter intervention (RR 0.77, 95% CI 0.54-1.09; P = 0.14). There were no significant differences in overall vascular complications (RR 0.78, 95% CI 0.59-1.04; P = 0.09), major bleeding (RR 0.83, 95% CI 0.51-1.36; P = 0.46), arterial stenosis (RR 0.81, 95% CI 0.55-1.20; P = 0.30), or 30-day mortality (RR 0.99, 95% CI 0.65-1.50; P = 0.96). However, SP was associated with a lower risk of arterial dissection (RR 0.32, 95% CI 0.15-0.70; P = 0.004).

Conclusion: In large-bore transfemoral transcatheter procedures, a single Perclose strategy was associated with a lower risk of arterial dissection compared to double Perclose and no significant difference for other major outcomes and complications.

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大口径动脉经股导管手术后使用单双过闭合缝合器的结果：荟萃分析和系统回顾。

背景：在大口径经股手术中，如经导管主动脉瓣置换术和血管内动脉瘤修复，单次（SP）与默认的双次（DP）动脉关闭策略的比较效果仍然不确定。方法：我们从2014年1月至2026年4月在PubMed、Scopus、Web of Science和Cochrane Library中进行了系统的文献检索，以确定比较SP和DP装置用于大口径经股动脉通路关闭的研究。结果包括设备/技术成功，需要计划外的手术或导管干预，30天死亡率，任何血管并发症，大出血，动脉夹层和动脉狭窄。采用反方差加权进行随机效应荟萃分析，并使用I2统计量评估异质性。结果：我们确定了2015年至2026年间发表或可获得的14项研究，包括6487名患者，未进行匹配或调整（SP 3518; DP 2969）。匹配后调整队列包括5077例患者（SP 2691; DP 2386）。SP与DP比较，器械/技术成功率相似（RR 1.02, 95% CI 1.00-1.03; P = 0.07），需要非计划的手术/导管干预（RR 0.77, 95% CI 0.54-1.09; P = 0.14）。两组在总体血管并发症（RR 0.78, 95% CI 0.59-1.04, P = 0.09）、大出血（RR 0.83, 95% CI 0.51-1.36, P = 0.46）、动脉狭窄（RR 0.81, 95% CI 0.55-1.20, P = 0.30）和30天死亡率（RR 0.99, 95% CI 0.65-1.50, P = 0.96）方面无显著差异。然而，SP与动脉夹层风险较低相关（RR 0.32, 95% CI 0.15-0.70; P = 0.004）。结论：在大口径经股导管手术中，单次Perclose与双次Perclose相比，动脉夹层风险较低，其他主要结局和并发症无显著差异。

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来源期刊

Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.30

自引率

5.90%

发文量

687

审稿时长

36 days

期刊介绍： Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.