Feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated vascular closure device.

BACKGROUND: Complications of venous vascular access are usually non-fatal but are the most common complications after transvenous catheter intervention. Vascular closure devices (VCD) have recently become available for venous closure.

OBJECTIVE: This study aimed to evaluate the feasibility and efficacy of real-time ultrasound-guided venous closure using suture-mediated VCD in patients who underwent catheter ablation.

METHODS: This single-center observational study enrolled 226 consecutive patients who underwent elective catheter ablation with femoral venipuncture. Regarding hemostasis, vessel closure using VCD was performed with real-time ultrasound guidance after 2022 (n=123) and without ultrasound guidance in 2021 (n=103). The occurrence of venous access site-related complications (major, minor, or other) was compared.

RESULTS: The rate of device failure was significantly lower in patients with ultrasound-guidance than in those without (1.6% vs. 6.3%; p=0.048). The occurrence of all venous access site-related complications was significantly lower in patients with ultrasound-guidance than in those without (4.9% vs. 18.4%, p=0.001). Time to ambulation was shorter in patients with ultrasound-guidance than in those without (2.0 ± 0.1 hours vs. 2.2 ± 0.6 hours, p < 0.001).

CONCLUSIONS: Real-time ultrasound guidance can reduce device failure, access site-related complications, and time to ambulation when performing venous closure with a VCD.