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American Heart Association

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Final ID: MP1583

Safety and Effectiveness of Vascular Closure Devices in the Electrophysiology Laboratory: a Systematic Review and Meta-analysis

Abstract Body (Do not enter title and authors here): Introduction: Manual compression and figure of eight sutures remain the standard practice (SP) for achieving hemostasis following venous access for electrophysiology (EP) procedures. However, vascular closure devices (VCDs) have emerged as alternatives designed to reduce time to hemostasis and ambulation without compromising patient safety. A conclusive comparison between VCDs and SP is lacking. This meta-analysis aims to evaluate the safety and effectiveness of VCDs compared with the SP in adult patients undergoing EP procedures.
Methods: Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) and observational studies comparing VCDs to SP in EP procedures. SP consisted of manual compression alone or with the addition of figure of eight sutures. Continuous outcomes were pooled as mean differences (MD), and binary outcomes as risk ratios (RR), both with 95% confidence intervals (CI), using a random-effects model. Analyses were conducted in R version 4.3.2.
Results: A total of 1,765 patients were included from nine studies, six of which were RCTs. VCDs were used in 916 (51.9%) patients. The majority of VCDs used were the Perclose ProGlide (66.6%). Follow-up ranged from 30 to 90 days. VCDs significantly reduced time to hemostasis (MD -7.03; 95% CI -8.77 to -5.28; p<0.01; Figure 1). Time to ambulation was also shorter in the VCD group (MD -2.70; 95% CI -3.65 to -1.75; p<0.0001). Although VCDs showed a nonsignificant trend toward reduced time to discharge (MD -5.44; 95% CI -22.28 to 11.39; p=0.38), they were associated with a significantly lower risk of access site hematomas (RR 0.22; 95% CI 0.07 to 0.70; p=0.01).
Conclusions: In patients undergoing EP procedures, VCDs significantly reduced time to hemostasis, time to ambulation, and access site hematoma rates compared with manual compression and figure of eight sutures. These findings support the adoption of VCDs as a safe, time-efficient alternative to conventional hemostasis methods.
  • Pereira, Vinicius  ( Universidad Austral , Pilar , Argentina )
  • Rodriguez Ferreira, Esteban  ( Universidad Nacional de Asuncion , Asuncion , Paraguay )
  • Lang, Maximiliano  ( Austral University Hospital , Pilar , Argentina )
  • Bivort, Mateo  ( Hopsital Austral , Pilar , Buenos Aires , Argentina )
  • Torres Heisecke, Raul  ( Tyler Cardiovascular Consultants, P , Tyler , Texas , United States )
  • Author Disclosures:
    Vinicius Pereira: DO NOT have relevant financial relationships | Esteban Rodriguez Ferreira: DO NOT have relevant financial relationships | Maximiliano Lang: DO NOT have relevant financial relationships | Mateo Bivort: No Answer | Raul Torres Heisecke: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2025

2025

New Orleans, Louisiana

Session Info:

Optimizing and Understanding Outcomes in Catheter Ablation and Complex Arrhythmia Management

Sunday, 11/09/2025 , 03:15PM - 04:15PM

Moderated Digital Poster Session

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