Methods of postcathetrisation haemostasis in peripheral vascular interventions

Advances in vascular interventional radiology as for example stentgraft implantation, drug eluting stents, mechanisms and tools for thrombus, embolus or atherosclerotic plaques removal (mechanical thrombectomy and atherectomy devices), intravascular ultrasound utilisation, pulse flow reserve measurement, massive use of modern antithrombotics, anticoagulants and fibrinolytics in cardiovascular medicine, together with epidemy of civilisation diseases (obesitas, hypertension, atherosclerosis, DM), population aging and polymorbidity lead to prolonged manual compression after diagnostic and therapeutic interventions with rapid increase in postpuncture complication rate, patient dyscomfort and prolonged treatment time. Percutaneous closure devices offer new potential possibility of decrease of time to hemostasis, time to ambulation, time to discharge and decrease in postcatheterisation complications after invasive procedures via arterial puncture site and also important rationalisation of department operation. The aim of the article is to offer the review of current methods in achiewing hemostasis after endovascular procedures with percutaneous closure devices from its first till second generation in diagnostic procedures, peripheral interventions up to the use of most sophisticated percutaneous closure devices in the treatment of thoracic and abdominal aorta diseases and our experience and observation with the use of percutaneous closure devices.

KEY WORDS:
Peripheral vascular interventions – Active hemostasis – Passive hemostasis – Postcatheterisation complications – Percutaneous closure devices