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. 2024 Sep;67(6):1437-1443.
doi: 10.1007/s10840-024-01773-3. Epub 2024 Feb 27.

Safety of multi-access site venous closure following catheter ablation of atrial fibrillation and flutter

Sanjaya Gupta  1   2 , Raghu Kolluri  3 , Tiessa Simoes  4 , Sandeep C Pingle  4 , Hong Nie  4 , Michael S Lloyd  5 , Daniel Steinhaus  6   7 , Stacy B Westerman  5 , Anand Shah  5 , Jessica Kline  6   7 , Soroosh Kiani  5   8
Affiliations

Safety of multi-access site venous closure following catheter ablation of atrial fibrillation and flutter

Sanjaya Gupta et al. J Interv Card Electrophysiol. 2024 Sep.

Abstract

Background: Following catheter ablation, vascular access management involves potential complications and prolonged recovery. Recently, suture-mediated closure (SMC) devices were approved for venous access procedures. The objective of this study is to evaluate the safety of a commercially available SMC for multiple access site venous closure by duplex ultrasound (DUS) in asymptomatic subjects with non-visible complications.

Methods: Thirty-six subjects (63 ± 10.7 years old, 12 female) were enrolled. Following catheter ablation for atrial fibrillation, all subjects had SMC of every venous access site. Subjects underwent DUS of femoral veins and arteries. DUS was performed at discharge, and again at 30 days. Subjects were evaluated for clinically apparent vascular complications.

Results: Mean procedure duration was 138.6 min, and the time to hemostasis was 3.1 min/access site and 9.5 min/subject. Median time to ambulation was 193.5 min, and median time to discharge was 5.95 h, with discharge as early as 2.4 h. A median of 2 sheaths/vein and a median of 2 SMC devices/vein were used. There were no major complications and a 16.7% (6/36) minor complication rate at discharge. All complications resolved at 30 days. The complication rate was not higher in patients with 2 SMC per access site as compared to the patients who just received 1 SMC per access site.

Conclusions: This study demonstrates the safety of multi-access closure using SMC, following catheter ablation procedures, for closure of sites that use sheath sizes from ≤ 8F to ≥ 15F and for those that use 2 or more SMCs per access site.

Keywords: Atrial fibrillation; Catheter ablation; Closure device; Duplex ultrasound.

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Conflict of interest statement

Dr. Gupta consults for Medtronic, Boston Scientific, and Respicardia. Dr. Kolluri is the President of Syntropic Core Lab and has consulted for Abbott, Boston Scientific, Medtronic, and other companies. Drs. Pingle, Simoes, and Nie are Abbott employees. Dr. Kiani was a member of the Abbott Vascular Closure Advisory Board in 2021.

Figures

Fig. 1
Fig. 1
Diagram illustrating patient enrollment, outcomes, and follow-up
See this image and copyright information in PMC

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References

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