ABSTRACT
This single-center, retrospective study describes using the VASCADE Vascular Closure System (Cardiva Medical, Inc, Santa Clara, California) to close 32 venous access sites in 21 consecutive patients (11 females; 10 males; age 45 y ± 19) after catheter-directed interventions. Sheath sizes were 5-10 F (8.7 F ± 1.7). Hemostasis was achieved in 30 of 32 deployments (93.8%). Complications were observed after 6 of 32 procedures, including 5 minor events in 4 patients and 1 major event in 1 patient which was likely unrelated to device deployment. The VASCADE device efficaciously closes venotomies after deep venous procedures, but further studies comparing it with manual compression are required to define its optimal use.
Subject(s)
Catheterization/adverse effects , Hemorrhage/prevention & control , Hemostatic Techniques/instrumentation , Vascular Closure Devices , Veins , Adolescent , Adult , Aged , Child , Child, Preschool , Equipment Design , Female , Hemorrhage/blood , Hemorrhage/etiology , Hemostasis , Hemostatic Techniques/adverse effects , Humans , Male , Middle Aged , New York City , Punctures , Retrospective Studies , Treatment Outcome , Veins/diagnostic imaging , Young AdultABSTRACT
BACKGROUND: Chronic venous occlusions can result in debilitating symptoms and can be refractory to standard methods of venous recanalization because of the formation of dense fibrous tissue. A transjugular liver access cannula can be incorporated into recanalization efforts to treat such refractory cases. This report describes our experience using the transjugular liver access cannula technique in nine patients. METHODS: A review of patients requiring venous recanalization between May 2012 and October 2014 identified nine cases that required the use of a transjugular liver access cannula as a guiding instrument. Lesion characteristics, technical success, and clinical outcomes were evaluated. RESULTS: The transjugular liver access cannula was used to traverse a total of nine chronic occlusions in both the upper and lower central venous systems in nine patients. The technical success rate was 100%. There were no clinically significant complications. One patient was lost to follow-up. Of the remaining eight patients, seven experienced symptomatic relief within 1 month of recanalization. CONCLUSIONS: The transjugular liver access cannula may serve as a useful adjunctive tool during difficult venous recanalizations, especially when traditional guidewire and catheter techniques fail.
