Vascular Complications after Percutaneous Coronary Intervention Following Hemostasis (see full title below)

Volume 22 - Issue 4 - April, 2010
Posted on: 3/31/10
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Pages:

175 - 178

Author(s):

Shah Azmoon, MD, Anthony L. Pucillo, MD, Wilbert S. Aronow, MD, Ramin Ebrahimi, MD, Joseph Vozzolo, MD, Archana Rajdev, MD, Kumar Kalapatapu, MD, Jae H. Ro, MD, Craig Hjemdahl-Monsen, MD

Vascular Complications after Percutaneous Coronary Intervention Following Hemostasis with the Mynx Vascular Closure Device Versus the AngioSeal Vascular Closure Device

ABSTRACT: We investigated the prevalence of vascular complications after PCI following hemostasis in 190 patients (67% men and 33% women, mean age 64 years) treated with the AngioSeal vascular closure device (St. Jude Medical, Austin, Texas) versus 238 patients (67% men and 33% women, mean age 64 years) treated with the Mynx vascular closure device (AccessClosure, Mountain View, California). Results. Death, myocardial infarction or stroke occurred in none of the 190 patients (0%) treated with the AngioSeal versus none of 238 patients (0%) treated with the Mynx. Major vascular complications occurred in 4 of 190 patients (2.1%) treated with the AngioSeal versus 5 of 238 patients (2.1%) treated with the Mynx (p not significant). Major vascular complications in patients treated with the AngioSeal included removal of a malfunctioning device (1.1%), hemorrhage requiring intervention (0.5%) and hemorrhage with a loss of > 3g Hgb (0.5%). The major vascular complications in patients treated with the Mynx included retroperitoneal bleeding requiring surgical intervention (0.8%), pseudoaneurysm with surgical repair (0.8%) and hemorrhage with a loss of > 3g Hgb (0.4%). These complications were not significantly different between the two vascular closure devices (p = 0.77). Minor complications included hematoma > 5 cm (0.5%, n = 1) within the AngioSeal group, as well as procedure failure requiring > 30 minutes of manual compression after device deployment, which occurred in 7 out of 190 patients (3.7%) treated with the AngioSeal versus 22 of 238 patients with the Mynx (9.2%) (p = 0.033). Conclusions. Major vascular complications after PCI following hemostasis with vascular closure devices occurred in 2.1% of 190 patients treated with the AngioSeal vascular closure device versus 2.1% of 238 patients treated with the Mynx vascular closure device (p not significant). The Mynx vascular closure device appears to have a higher rate of device failure.

J INVASIVE CARDIOL 2010;22:175–178

Key words: vascular closure device, Mynx, AngioSeal, hemorrhage, percutaneous coronary intervention, pseudoaneurysm