Feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated vascular closure device

BACKGROUND Venous vascular access complications are usually nonfatal but are the most common complications after trans- venous catheter intervention. Vascular closure devices (VCDs) have recently become available for venous closure. OBJECTIVE This study aimed to evaluate the feasibility and efficacy of real-time ultrasound-guided venous closure with suture- mediated VCDs in patients who underwent catheter ablation. METHODS This single-center observational study enrolled 226 consecutive patients who underwent elective catheter ablation with femoral venipuncture. For hemostasis, vessel closure by VCD was performed with real-time ultrasound guidance after 2022 (n = 123) and without ultrasound guidance in 2021 (n = 103). The occurrence of venous access site-related complications (major, minor, or other) was compared. RESULTS The rate of device failure was significantly lower in patients with ultrasound guidance than in those without (1.6% vs 6.3%; P = . 048). The occurrence of all venous access site-related complications was significantly lower in patients with ultrasound guidance than in those without (4.9% vs 18.4%; P = . 001). Time to ambulation was shorter in patients with ultrasound guidance than in those without (2.0 +/- 0.1 hours vs 2.2 +/- 0.6 hours; P < .001). CONCLUSION Real-time ultrasound guidance can reduce device failure, access site-related complications, and time to ambulation in performing venous closure with a VCD.