: Transfemoral access is nowadays required for an increasing number of percutaneous procedures, such as structural heart interventions, mechanical circulatory support, and interventional electrophysiology/pacing. Despite technological advancements and improved techniques, these devices necessitate large-bore (≥12 French) arterial/venous sheaths, posing a significant risk of bleeding and vascular complications, whose occurrence has been related to an increase in morbidity and mortality. Therefore, optimizing large-bore vascular access management is crucial in endovascular interventions. Technical options, including optimized preprocedural planning and proper selection and utilization of vascular closure devices, have been developed to increase safety. This review explores the comprehensive management of large-bore accesses, from optimal vascular puncture to sheath removal. It also discusses strategies for managing closure device failure, with the goal of minimizing vascular complications.

Paraggio, L., Bianchini, F., Aurigemma, C., Romagnoli, E., Bianchini, E., Zito, A., Lunardi, M., Trani, C., Burzotta, F., Femoral Large Bore Sheath Management: How to Prevent Vascular Complications From Vessel Puncture to Sheath Removal, <<CIRCULATION. CARDIOVASCULAR INTERVENTIONS>>, 2024; (N/A): N/A-N/A. [doi:10.1161/CIRCINTERVENTIONS.124.014156] [https://hdl.handle.net/10807/288178]

Femoral Large Bore Sheath Management: How to Prevent Vascular Complications From Vessel Puncture to Sheath Removal

Bianchini, Francesco;Aurigemma, Cristina;Romagnoli, Enrico;Bianchini, Emiliano;Zito, Andrea;Trani, Carlo;Burzotta, Francesco
2024

Abstract

: Transfemoral access is nowadays required for an increasing number of percutaneous procedures, such as structural heart interventions, mechanical circulatory support, and interventional electrophysiology/pacing. Despite technological advancements and improved techniques, these devices necessitate large-bore (≥12 French) arterial/venous sheaths, posing a significant risk of bleeding and vascular complications, whose occurrence has been related to an increase in morbidity and mortality. Therefore, optimizing large-bore vascular access management is crucial in endovascular interventions. Technical options, including optimized preprocedural planning and proper selection and utilization of vascular closure devices, have been developed to increase safety. This review explores the comprehensive management of large-bore accesses, from optimal vascular puncture to sheath removal. It also discusses strategies for managing closure device failure, with the goal of minimizing vascular complications.
2024
Inglese
Paraggio, L., Bianchini, F., Aurigemma, C., Romagnoli, E., Bianchini, E., Zito, A., Lunardi, M., Trani, C., Burzotta, F., Femoral Large Bore Sheath Management: How to Prevent Vascular Complications From Vessel Puncture to Sheath Removal, <<CIRCULATION. CARDIOVASCULAR INTERVENTIONS>>, 2024; (N/A): N/A-N/A. [doi:10.1161/CIRCINTERVENTIONS.124.014156] [https://hdl.handle.net/10807/288178]
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