Comparing Perclose to Statseal With Perclose in Transcatheter Aortic Valve Replacement Arteriotomy Closure

University of California, Los Angeles50 enrolled

Overview

The purpose of this clinical study is to compare how well two different devices achieve hemostasis in patients undergoing a transfemoral transcatheter aortic valve replacement. Both devices are approved by the FDA for this use, and have already been used by clinicians on patients undergoing transfemoral procedures. It is believed that the use of both devices in combination compared to the Perclose alone will shorten the time that it takes to 'seal' the artery, resulting in a shorter period of time that manual pressure will be held, shorter procedure time and less complications after the procedure.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Arterial Occlusion Cardiovascular Diseases Hematoma

Interventions

Patients will have a PercloseTM device deployed at the arteriotomy. Manual pressure will be held for at least five minute, the beginning of which will correspond to time point zero. Patent hemostasis will be documented after device deployment. Any manual compression needed or per protocol under the disgression of the operator will count towards the time to hemostasis. After hemostasis is achieved in the cath lab the patient will be sent to the post-operative area for monitoring. If any additional bleeding is appreciated, manual compression will again be held. If any new bleeding from the puncture site or under the skin the patient will again lay supine and at least 10 minutes of manual pressure will be held. This will be continued until the patient has no bleeding.

StatsealDEVICE

Patients will have a PercloseTM device deployed at the arteriotomy. A Statseal disc will applied and manualpressure will be held for at least five minute, the beginning of which will correspond to time point zero. Patent hemostasis will be documented after device deployment. Any manual compression needed or per protocol under the disgression of the operator will count towards the time to hemostasis. After hemostasis is achieved in the cath lab the patient will be sent to the post-operative area for monitoring. If any additional bleeding is appreciated, manual compression will again be held. If any new bleeding from the puncture site or under the skin the patient will again lay supine and at least 10 minutes of manual pressure will be held. This will be continued until the patient has no bleeding.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Delivery of a 14-16 French Transcatheter aortic valve replacement system Exclusion Criteria: * Use of a hemostasis method or device besides PercloseTM (Perclose may not be used in situations of heavy calcification, presence of dissection, etc). * Use of an anticoagulant other than unfractionated heparin or bivalirudin during the procedure. * Any use of glycoprotein inhibitors or cangrelor. * Use of sheathless guides. * Any anticipated need for continued anticoagulation post-catheterization, including extended bivalirudin infusion. * Any active treatment with oral anticoagulants continued during course of procedure. * Presence of arteriovenous dialysis fistula in the ipsilateral leg. * Any physical deformity or trauma / injury of the leg that would prevent proper placement or function of the hemostasis band. * Inability of the patient to personally consent for the study. (no surrogate consent) * Cardiogenic shock, emergent procedures (high risk myocardial infarctions), or any clinical instability as assessed by the physician performing the procedure.

Outcomes

Primary Outcomes

Time to Hemostasis

From the time of manual compression after PercloseTM deployed until hemostasis is achieved without complication.

Time frame: 24 hours post procedure (± 1 hour)

Secondary Outcomes

Patients With Hematoma

Presence of small \<5cm, medium 5-10cm, or large \>10cm hematoma based on physical exam or diagnostic imaging.