Propensity matched analysis of bleeding and vascular complications associated with vascular closure devices vs standard manual compression following percutaneous coronary intervention.

BACKGROUND: In patients undergoing percutaneous coronary intervention (PCI), controversy exists regarding the effect of vascular closure device (VCD) use on bleeding and vascular complications with limited data available for comparison of the different devices. METHODS: We developed propensity score matched groups, manual compression (MC) (n = 1,407) and VCD (n = 2,814), who underwent PCI in an eight-year period and compared their bleeding and vascular complications. Vascular closure device subtype analysis was also done. RESULTS: Compared to MC, the VCD group had lower rates of hematoma > or = 10 cm (1.1% vs 2.1%, P < 0.01). Angioseal use was associated with the highest rate of surgical repair. Perclose had the lowest rates of bleeding and the lowest composite outcome of all vascular and bleeding complications at 5.6% vs 9.2% forAngiosealand 10.2% for Starclose (P < 0.001). CONCLUSION: In patients undergoing PCI, VCD use is a safe method for achieving femoral artery hemostasis. Perclose use is associated with the least complications.