Commentary. Use of the 8-F Angio-Seal vascular closure device for much larger sheaths: Successfully fitting a square peg into a round hole?

摘要

Endovascular therapy requires, by definition, transcatheter access to arteries or veins. Accordingly, successfully managing the access site, in terms of safe vessel puncture, sheath deployment (when required), and he-mostasis during and at the end of the procedure, represents one of the pivotal steps of any endovascular procedure. This holds even truer when large devices, with accompanying large-diameter (>8-F) sheaths are required, as the risk of complications is directly proportional to sheath diameter.1 Despite advancements in techniques and devices, including miniaturization of sheaths and catheters, large devices are being used with increasing frequency given the introduction of novel catheter-based techniques, such as transcatheter aortic valve implantation.