Recommendations on the safety and effectiveness of vascular closure devices have been released by an American Heart Association expert panel made up of physicians and researchers, including two cardiologists from Baylor College of Medicine and the Michael E. DeBakey VA Medical Center.

Guidelines needed

"Each year more than 6 million invasive cardiovascular procedures are performed worldwide, and the majority of these procedures use some type of vascular closure device," said Dr. Hani Jneid, assistant professor of medicine and interventional cardiologist at BCM and the Michael E. DeBakey VA Medical Center. "Many times these devices are overused for certain procedures or used with the purpose of preventing complications. There is no definitive evidence, statement, guidelines to help direct the practicing invasive cardiologists on the use of these devices."

In response to this concern, members of the Council on Clinical Cardiology of the American Heart Association, along with the Council on Cardiovascular Radiology and Intervention, and the Council on Peripheral Vascular Disease, worked jointly to objectively and systematically review the existing evidence and provide non-binding guidelines on the use of vascular closure devices.

A set of recommendations was created by this group and outlined in a recent edition of the medical journal Circulation.

Panel's goal

"Vascular closure devices are used by invasive cardiologists and vascular surgeons to close the femoral artery after diagnostic and interventional cardiovascular procedures and include a wide range of instruments," said Jneid, who was on the panel and co-authored the statement of recommendations. "As we drafted these recommendations, our goal was to provide an overview of the benefits and risks of these devices and help guide the physicians as they decide which instrument is best for each procedure and patient."

The AHA Statement focuses on when to use the devices to achieve faster clotting and shorter bed rest, and compares their effectiveness with alternative approaches, such as manual compression. It also gives recommendations for the use of these instruments during clinical trials and includes information on how the use of these devices and their complications should be recorded for future reviews.

"Our hope is that these recommendations are considered by doctors to help them enhance patient care," said Jneid.

Others who are a part of the panel include Dr. Glenn N. Levine, professor of medicine - cardiology at BCM, and Drs. Manesh R. Patel, Colin P. Derdeyn, Lloyd W. Klein, Robert Lookstein, Christopher J. White, Yerem Yeghiazarians, and Kenneth Rosenfield on behalf of the American Heart Association Diagnostic and Interventional Cardiac Catheterization Committee of the Council on Clinical Cardiology, Council of Cardiovascular Radiology and Intervention and the Council on Peripheral Vascular Disease.

Complete list of recommendations and disclosures related to the panel.