Antegrade use of a collagen based vascular closure device for day case peripheral stenting: when can we safely discharge the patients?

Iftikhar Zaman, Tariq Ali, Cormac O’Neil, Renganaden Pyneeandee, Miltiadis Krokidis


Purpose: Vascular closure devices have revolutionised vascular intervention, offering early patient mobilisation after retrograde access. The purpose of this study is to assess the safety and cost saving performance of a collagen based closure device in the early mobilisation of patients that undergo antegrade peripheral stenting as day cases.

Material and Methods: We retrospectively reviewed our radiology day unit database for antegrade stenting cases in a four-year period. We included 26 patients where a collagen based closure device was used. Patients were analysed for size of sheath used, Rutherford classification, degree of calcification (score from 1-4) of the access artery, amount of inraprocedureal heparin, type of stent used, time of discharge, immediate and delayed complications. Cost analysis also followed aiming to identify potential cost benefits of the device.

Results: A 6 Fr sheath was used in all cases. 11/26 patients were Rutherford 5-6 classification. The degree of calcification was >3 in 20/26 patients. In all patients at least 3000 IU of heparin were used intraprocedurally. Two types of stents were used; the time of discharge was 4 hours. In two cases a small haematoma was detected but did not change the management of the patients. No delayed groin complications occurred.  Bed turnover was 50% less than with the traditional 6-hour stay, leading to significant reduction of the healthcare costs.

Conclusions: The use of a collagen based closure device offers satisfactory day case results for patients with advanced peripheral disease that undergo antegrade stenting, with reduction of the overall procedure cost.


Peripheral vascular intervention; Antegrade access; Vascular closure devices; Day-case angioplasty

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