C04 - Comparison of Vascular Closure Techniques in Dogs Undergoing Percutaneous Transcatheter Intervention

Abstract: Background: Manual compression has been the standard-of-care for maintaining hemostasis after percutaneous endovascular intervention, but can be time-consuming and associated with vascular complications. Alternative closure methods include temporary figure-of-eight suture (Z-stitch) and vascular closure device (VCD) techniques.

Hypothesis: We hypothesized that compared to manual compression, Z-stitch and VCD would significantly reduce time-to-hemostasis, and the proportion of dogs with vascular patency among treatments would not differ significantly.

Animals: Twenty-one client owned dogs undergoing percutaneous transvenous interventional procedures.

Methods: Dogs with vessel diameter < 5mm were randomized to undergo manual compression (n = 6) or Z-stitch (n = 7). Dogs with vessel diameter ≥5mm were randomized to undergo manual compression (n = 2), Z-stitch (n = 2), or VCD (n = 4). Time to hemostasis, Bleeding Academic Research Consortium (BARC) score, and presence of vascular patency at 24 hours were recorded. Data are presented as median (95% CI).

Results: Median time to hemostasis was significantly shorter in Z-stitch (2.9 [1.6-4.0] min) versus manual compression (10.0 [10.0-20.0] min; p < 0.001) or VCD (8.5 [8.1-11.8] min); p < 0.003) groups, and in VCD versus manual compression (p=0.018) groups. At 5 minutes, BARC scores were significantly higher (consistent with worse bleeding), in the manual compression, versus Z-stitch (p=0.005), but not VCD (p=0.16) groups. There was no difference in the proportion of dogs with vascular patency at 24 hours among methods (7/8, 4/4 and 9/9 in manual compression, VCD, and Z-stitch groups, respectively; p=0.57).

Conclusions: Z-stitch and VCD are effective hemostasis methods, with Z-stitch providing the most rapid hemostasis.