ABSTRACT

Percutaneous techniques to treat coronary artery disease, and more recently valvular heart disease, have revolutionised the field of cardiology. These procedures involve arterial access with the inherent risk of access site bleeding. The rate of vascular complications associated with trans-femoral access ranges from 0.3" to 1" in diagnostic catheterisation and 1"-5" in PCIs. Bleeding complications from femoral access are associated with increased morbidity and mortality. Mechanical compression devices are passive standalone vascular closure devices (VCDs). The concept of mechanical compression devices is similar to manual compression, that is to apply pressure over the arterial puncture site. Haemostatic pads are adjuncts to manual or mechanical compression. They contain procoagulant material embedded in them. Apart from haemostatic pads and mechanical compression devices, passive arteriotomy closure devices exist that enhance the haemostatic process via wire-stimulated track thrombosis. Haemostatic devices for both radial and femoral arterial access have come a long way.