An arterial closure device may be used at the site of percutaneous arteriotomy in order to help control bleeding, especially if thrombolytic, anticoagulants or antiplatelet agents have been used. This reduces the amount of time that a patient must stay immobile and allows for early discharge following the procedure, but the use of these devices have been associated with a number of complications.



(1) bleeding, including hematoma formation and need for transfusion

(2) pseudoaneurysm

(3) arteriovenous fistula

(4) thrombosis (especially if a procoagulant is used and injected within the lumen of the artery)

(5) emboli

(6) infection (abscess, sepsis, endarteritis, other; see Chapter 26)


Risk factors for complications:

(1) large catheter diameter

(2) bleeding disorder

(3) use of a closure device within the previous 6 weeks (Hamner et al)

(4) break in sterile technique


Contraindications to use of the closure device (Resnic et al, Silber et al), presumably due to the risk of significant complications:

(1) severe peripheral vascular disease

(2) severe coagulopathy

(3) hematoma at access site

(4) delayed removal of the vascular access sheath (more than 1 hour)

(5) uncontrolled hypertension


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