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Hepatic and splenic venous access tract closure using the VASCADE vascular closure system following percutaneous intervention in patients with CHD

Published online by Cambridge University Press:  13 September 2024

Lindsay F. Eilers ,
Manish Bansal ,
Asra Khan ,
Melissa K. Webb ,
Athar M. Qureshi ,
Srinath T. Gowda  and
Gary E. Stapleton Open the ORCID record for Gary E. Stapleton [Opens in a new window]
Lindsay F. Eilers
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Manish Bansal
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Asra Khan
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Melissa K. Webb
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Athar M. Qureshi
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Srinath T. Gowda
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Gary E. Stapleton*
Affiliation:
Charles E. Mullins Cardiac Catheterization Laboratories, Texas Children’s Hospital, and Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
*
Corresponding author: Gary E. Stapleton; Email: gstapleton68@gmail.com
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Abstract

Background:

Hepatic and splenic venous access are specialised techniques used to perform diagnostic and interventional procedures in the cardiac catheterisation laboratory. Bleeding events are the most commonly reported complication following hepatic or splenic venous access. The VASCADE Vascular Closure System (Cardiva Medical Inc. Santa Barbara, CA) is an approved device for closure of femoral vascular access tracts in patients ≥18 years of age. We report our experience using VASCADE to close the hepatic or splenic venous access site in the cardiac catheterisation laboratory.

Methods:

This is a single centre retrospective review of all patients who had percutaneous hepatic or splenic venous access obtained in the cardiac catheterisation laboratory from March 1, 2022 through October 30, 2023 and underwent tract closure with VASCADE.

Results:

Ten patients (six male) underwent 16 procedures (median age and weight 3.5 years and 12.5 kg) with 15 hepatic and two splenic veins accessed. Successful closure of the access tracts with VASCADE was performed in all patients. There were no major adverse events related to closure of the access sites with VASCADE.

Conclusion:

VASCADE can be used following transhepatic and trans-splenic venous access in the cardiac catheterisation laboratory to safely close the access tract and potentially reduce the risk of post-procedural bleeding complications. Further evaluation in a larger cohort of patients is needed to ensure VASCADE is safe for use and provides adequate haemostasis following hepatic or splenic venous access, particularly in children.

Keywords

cardiac catheterisationhepaticsplenicVASCADE Vascular Closure System
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 4
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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