ABSTRACT
Access-related complications are the most common complication of endovascular procedures. Additional methods using vascular closure devices (VCDs) have been developed with the intent to minimize manual compression time and allow earlier return to ambulation. Factors to consider prior to sheath removal and vessel closure are patient comfort and ability to lay supine for a prolonged period of time, degree of anticoagulation, and blood pressure. Although rare, VCDs have been shown to increase the risk of leg ischemia, groin infection, and complications requiring surgical repair compared with manual compression. If a VCD fails, manual compression can be used to achieve hemostasis. Additional manual compression is required for up to 5 minutes or until hemostasis is achieved. External mechanical compression devices such as the FemoStop are also available.
