To compare the efficacy, primary failure rates, and complications for the Angio-Seal and Perclose closure devices in antegrade and retrograde common femoral artery (CFA) punctures during peripheral angioplasty procedures.Methods:
A retrospective single-center analysis was conducted between April 2002 and June 2006 of all patients who had a CFA puncture and no other intervention planned during the same admission. Patients undergoing thrombolysis were excluded. Of 215 punctures in 191 patients, 123 closures in 97 patients (82 men; mean age 69.5 ±10.4 years, range 41-93) were eligible for analysis. Of these, 49 punctures were antegrade and 74 were retrograde. An Angio-Seal device was used in 40 closures, while 83 punctures were closed with a Perclose device. Deployment outcomes and complications were compared between devices for each puncture direction and between antegrade and retrograde punctures.Results:
Seventy-eight (63.4%) of the 123 closures reached the primary endpoint of complication-free progress to discharge, comprising 30 (61.2%) of the 49 antegrade closures and 48 (64.9%) of the 74 retrograde closures. There was no significant difference between the devices for the primary endpoint. Twenty-two (17.9%) attempted closures failed. Forty-one (33.3%) closures had a complication after the procedure, but none required further intervention. In antegrade closures, Angio-Seal had a significantly lower rate of primary failure (11.1% versus 38.7% for Perclose, p = 0.038). Antegrade closures had a higher rate of primary failure (p<0.01); however, this did not translate into any significant differences in postprocedural complications. No significant differences in primary failure or complication rates were found between the devices when used in retrograde punctures.Conclusion:
Angio-Seal had a lower rate of primary failure than Perclose in antegrade puncture closures. We believe this reinforces the need for larger studies to compare closure devices in antegrade punctures.