From the Journal

A Prospective, Randomized, Pivotal Trial of a Novel Extravascular Collagen-Based Closure Device Compared to Manual Compression in Diagnostic and Interventional Patients

James B. Hermiller, MD1;  Wayne Leimbach, MD2;  Roger Gammon, MD3;  Steven P. Karas, MD4; Robert J. Whitbourn, MD5;  S. Chiu Wong, MD6;  Nilesh Goswami, MD7;  John McCabe, MD8;  Nick G. Cavros, MD9;  Richard Paulus, MD10;  Srihari S. Naidu, MD11;  Zoltan G. Turi, MD12

The RESPECT trial was a multicenter, randomized comparison that evaluates the safety/efficacy of the new Vascade extravascular closure system (Cardiva Medical, Inc) in diagnostic and interventional procedures. Compared to manual compression, Vascade use reduced rates of minor access-site related complications, and significantly shortened time to hemostasis, time to ambulation, and time to discharge eligibility....

Commentary: Where Are We With Vascular Closure Devices After Percutaneous Arteriotomy?

Marc Cohen, MD

A discussion of the RESPECT trial results, and potential issues involved in achieving hemostasis with the new Vascade extravascular closure system (Cardiva Medical, Inc) is provided. While there is no formal economic analysis, Dr. Cohen believes that Vascade device presents a winning proposition in the current medical environment, since it has the potential to optimize resources and reduce length of stay. ...

Adoption of the Hybrid CTO Approach by a Single Non-CTO Operator: Procedural and Clinical Outcomes

Minh N. Vo, MD1;  James M. McCabe, MD2;  William L. Lombardi, MD2;  John Ducas, MD1; Amir Ravandi, MD, PhD1;  Emmanouil S. Brilakis, MD, PhD3

This study tested the feasibility of adopting the “hybrid” approach by a single operator without prior experience in CTO-PCI. The authors conclude that the “hybrid” approach to CTO-PCI can be successfully adopted by a single operator with excellent early procedural success and low complication rates, despite a lack of prior CTO-PCI experience....

Commentary: CTO-PCI: An Emerging New Subspecialty in Interventional Cardiology

Philip Green, MD and Dimitri Karmpaliotis, MD

CTO-PCI has emerged as a new subspecialty of interventional cardiology; modern CTO operators have set a new benchmark for CTO success rates of above 90%. With appropriate training and dissemination of the hybrid approach to new operators in the academic as well as community setting, this goal can be accomplished.  ...

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