Vascular Closure and Devices Flashcards

1
Q

What is the limitation of using one Perclose, Angio-Seal, or Mynx device for sheaths above 10 Fr?

A

They cannot be closed with one device

Vascular closure may be performed by deploying two Perclose ProGlide sutures in a “preclose” fashion.

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2
Q

What is the Manta vascular closure device designed for?

A

Large-bore procedures requiring devices up to 19 Fr

The device is currently not approved in the United States.

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3
Q

What was the success rate reported in the first prospective feasibility study of the Manta device?

A

94% success rate at hemostasis

The study included 50 patients and reported one major complication requiring vascular surgery.

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4
Q

What is the instruction for re-entry at the same location of previous Angio-Seal device use within 90 days?

A

Re-entry 1 cm proximal to the previous access site can be performed safely

A femoral angiogram of the site is indicated before considering Angio-Seal use.

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5
Q

True or False: The Mynx device was associated with a decreased risk of vascular complications.

A

False

Use of the Mynx device was associated with an increased risk of any vascular complications.

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6
Q

What is a pseudoaneurysm and how is it typically managed if size is less than 1 cm?

A

An infrequent complication of transradial catheterization, usually managed conservatively

Thrombin injection is not recommended for radial artery pseudoaneurysms.

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7
Q

What is the most likely explanation for acute limb ischemia in a patient post-procedure?

A

Acute dissection with thrombotic occlusion

This requires urgent imaging and intervention.

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8
Q

What is the best next step in managing a radial artery perforation?

A

Cross the perforation with a 0.014-in. wire and place a long sheath

This results in tamponade of the vessel.

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9
Q

List three advantages of vascular closure devices.

A
  • Reduced time spent in manual compression
  • Improved patient flow
  • Earlier ambulation for some patients
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10
Q

What does the American Heart Association (AHA) recommend regarding the routine use of closure devices?

A

Class III recommendation against routinely using closure devices to reduce vascular complications

This is based on their scientific statement.

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11
Q

What device is associated with a risk of major complications from vascular closure devices?

A

1% to 2% risk

This includes complications such as acute femoral artery thrombosis.

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12
Q

What common comorbidities were identified in closure device-related infections?

A
  • Diabetes mellitus
  • Obesity
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13
Q

What is the median incubation period for access-site infection after device insertion?

A

8 days

The range is from 2 to 29 days.

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14
Q

What imaging is useful for diagnosing a pseudoaneurysm?

A

Ultrasound imaging

This can help make the diagnosis and guide management.

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15
Q

What complication may occur with a ‘high stick’ access site?

A

Increased incidence of retroperitoneal hemorrhage

Closure device use is also associated with this complication.

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16
Q

What is the risk associated with using closure devices in patients with severe atherosclerosis at the access site?

A

None of the currently available devices are approved for use

This includes extravascular closure devices.

17
Q

What symptoms are consistent with a pseudoaneurysm?

A
  • Pulsatile mass
  • Audible bruit
18
Q

What are the components of the Angio-Seal device?

A
  • Polylactic–glycolic acid anchor
  • Bioresorbable collagen suture
  • Bovine collagen extravascular sponge
19
Q

Fill in the blank: The incidence of acute vessel closure at the time of device deployment has decreased to <_______ in most series.