Re-opening a blocked heart artery isn't the only procedure that concerns doctors when they thread instruments through an opening in a thigh artery and into a heart artery. Closing up the thigh artery is also a concern.
Arteriotomy -- the process of creating a hole in an "access artery" through which instruments are inserted -- is the first step in procedures like angiography (to visualize blockage in the heart or neck arteries) or percutaneous coronary intervention (to re-open blocked heart arteries).
A new statement from the American Heart Association addresses the use of arteriotomy closure devices. Arteriotomy closure is typically done manually, but more devices are entering the market to offer potential improvements over manual closure. The statement is published in Circulation: Journal of the American Heart Association.
The statement authors conclude that the devices are reasonable to use -- and they offer recommendations for their use based on available evidence -- but their benefits should be weighed against the risk of complications in patients. Patient-specific factors like age, gender, and disease severity should be considered before using an arteriotomy closure device.
The statement also includes recommendations for future trials and end points needed to inform clinical practice.
Co-authors are: Hani Jneid, M.D.; Colin P. Derdeyn, M.D.; Lloyd W. Klein, M.D.; Glenn N. Levine, M.D.; Robert Lookstein, MD, FAHA; Christopher J. White, M.D.; Yerem Yeghiazarians, M.D.; and Kenneth Rosenfield, M.D. Author disclosures are on the manuscript.
- In the Unites States in 2006, the most recent year for which data is available:
- 1,313,000 percutaneous coronary intervention (PCI) procedures were performed
- Average hospital charges for catheter procedures:
- PCI -- $51,445
- diagnostic cardiac catheterization (no stent implantation) -- $31,181
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