Author + information
- S1936879815021445-99045d607282e2db6259dae4e3e99ba7Kenta Nakamura1,
- S1936879815021445-a2af16989a32130b23e20497bcf86ba2Lynn Bailey2,
- S1936879815021445-317baee55b3b4837b31322622a3c2ef1Todd Grintz3,
- S1936879815021445-09aee1c72832f13ba33e2a6aac1163d9John Keating2 and
- S1936879815021445-567242436a2032ee7ccbcee9dff84e45Elazer R. Edelman4
Vascular access site complications are a significant source of morbidity following percutaneous catheterization, particularly for interventions requiring large bore cannulation such as transcatheter aortic valve replacement (TAVR). The benefit of vascular closure device (VCD) over manual compression is most pronounced for large bore access and higher baseline risk. We report a novel vascular closure device (VCD) that utilizes a collagen implant secured by intraluminal anchor and is specifically designed for large bore cannulation.
Three Yorkshire swine underwent surgical laparotomy to expose the abdominal aorta. Three 18 French vascular access sites were obtained in each animal and closed with the VCD. Angiography was performed on Days 0, 15 and prior to necropsy. Limited necropsy was performed at Days 30, 90, and 180 for histomorpholoigcal analysis.
All nine VCD deployments achieved patent hemostasis on first attempt as assessed by gross inspection and angiography. Serial histomorpholoigcal analysis revealed complete dissolution of implant collagen and presence of neointimal endothelialization of the prosthetic anchor by Day 90 day (Figure). Histological evidence of thrombosis was minimal at Day 30 and subsequently absent thereafter, and neointimal or adventitial fibrosis was minimal at all timepoints. There was no evidence of vascular occlusion or other complication at anytime.
The novel VCD successfully closed large bore arterial access in swine without complication and favorable healing characteristics as assessed by serial histomorphology. This VCD is a promising platform for rapid, effective, and safe large bore arterial closure.