This study examines in the safety and efficacy of using a single Perclose escalation technique (SPET) using a single Perclose Proglide device to preclose and the need for a rescue device based on a control angiography at the end of the procedure, with a 6F femoral sheath.
Percutaneous femoral access is the preferred access route for transcatheter aortic valve replacement (TAVR). The majority of experienced TAVR centers use two 6F Perclose ProGlide™ devices to close the primary vascular access site, deployed prior to upsizing sheath size with closure completed at the end of the case (the double "preclose" approach). A strategy of utilizing a single Perclose device to preclose may have advantages including fewer complications, complexity, and cost, but the safety of this is unknown. This study examines in the safety and efficacy of using a single Perclose escalation technique (SPET) using a single Perclose Proglide device to preclose and the need for a rescue device based on a control angiography at the end of the procedure, with a 6F femoral sheath. The use of Femoseal in mild bleedings, and a second Perclose Proglide for moderate to severe bleedings. Compare this SPET technique with double Preclose technique, with two historical cohorts of patients. One cohort of patients with SPET technique since started this technique, and a second cohort with double perclose technique prior to starting SPET technique.
Study Type
OBSERVATIONAL
Enrollment
300
One Perclose Proglide Suture
One Perclose Proglide Suture
Hospital Universitari Vall D'Hebron
Barcelona, Spain
SAFETY:Incidence of Intrahospital Major Vascular Complications and Bleeding type 2 or type >2 (according to VARC 3 criteria)
Intrahospital Major Vascular Complications and Bleeding type 2 or type \>2 (according to VARC 3 criteria)
Time frame: 30 days
EFFICACY:Incidence of successful femoral closure
Complete hemostasis at the puncture site with manual compression after the initial perclosure strategy
Time frame: 30 days
Cost-effectiveness evaluation
Cost-effectiveness evaluation between two techniques
Time frame: 30 days
Incidence of vascular complications (according to VARC3 criteria)
Incidence of vascular complications (according to VARC3 criteria)
Time frame: 30 days
Incidence of bleeding (according to VARC3 criteria)
Incidence of bleeding (according to VARC3 criteria)
Time frame: 30 days
All-cause Mortality
All-cause Mortality 30 days after procedure
Time frame: 30 days
All-cause Mortality
All-cause Mortality 1 year after procedure
Time frame: 1 year
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