Non-invasive closure devices

Dinith88 · Mar 5, 2004

I dont work cath-lab, but when we/i pull sheaths post-ptca we'll occaisionally use the syvek patch. We've just recently acquired the newer syvek (it's a little thicker and is impregnated w/like 4-8 x's (?) the amount of super-duper-clotting stuff than the origional).

It's been my experience that both types of syvek patches work well. However, we don't guage their success on how quickly the patient is up and ambulating, but rather on the hold-time and number of post-pull complications we've seen. The sheaths we pull are usually on pt's who've suffered AMI...so we don't push them to ambulate 4hrs post pull (rather than the typical 6...) In fact, we'll encourage them to stay down a wee longer than they need to. I like the syvek patch, and would recommend them.

BJNurse · Mar 6, 2004

If your looking for a non invasive "pad" type device the D-Stat dry has my vote. It is similar to the closur pad but doesn't stick to your fingers and tear apart. I also think that I get better more reliable hemostasis with it. It requires a 10 minute hold and I have had success pulling even while Integrillin or Reopro are infusing so long as your ACT and BP are okay. Vasomedical makes this device, the same people that make Duett.

cathlabrn · Mar 9, 2004

I have a question for those of you who are working in the cath lab. What are you using for non-invasive (patch) type closure devices? We have tried the Chito-seal and ClosurePad and have had multiple failures and less than stellar results with both. I have read about several other products and am looking to try some that may give our unit the safety and savings patches were touted to provide. Has anyone had experience with others, Syvek, etc. and what were your impressions? Have you used these products in lieu of interventional devices? My understanding is the newer Syvek NT can provide similar ambulation times to the invasive devices and this would be a HUGE cost savings? Any thoughts on this would be appreciated. Thanks in advance. :wink2:

We try to use angioseal whenever we can. It has been great. We used syvek for years, but then changed to Chito and really haven't experienced any problems. What problems have you been having? What is your ACT required before pulling? We have used the new syvek NT and are not super impressed for routine sticks. It seems to be an advantage for large sheath sizes, which we use rarely.

TriNeo · Mar 18, 2004

While we're on this topic, does anyone know what the prices are for the various non-invasive devices? My understanding is that they are all around $50. Is one more expensive than another? If so, do you think the extra cost is justified?

Look forward to your responses.

Best,

-T

Lino Lopez · May 13, 2004

I have worked with the patches for the past year and I am convinced that they are the best. The problem comes when nurses use manual pressure just like when they are holding manual pressure on a puncture site. The key to the successfull use of patches is to hole pressure lightly and allow some blood to soack the patch while holding firm pressure to the site. the blood will stop and you will achieve hemostasis in about 5 minutes with no complications. I have been using this method with 100% success. if you require more info please contact me at [email protected]

I am convinced that these patches are the best.

I have a question for those of you who are working in the cath lab. What are you using for non-invasive (patch) type closure devices? We have tried the Chito-seal and ClosurePad and have had multiple failures and less than stellar results with both. I have read about several other products and am looking to try some that may give our unit the safety and savings patches were touted to provide. Has anyone had experience with others, Syvek, etc. and what were your impressions? Have you used these products in lieu of interventional devices? My understanding is the newer Syvek NT can provide similar ambulation times to the invasive devices and this would be a HUGE cost savings? Any thoughts on this would be appreciated. Thanks in advance. :wink2:

Lino Lopez · May 13, 2004

I have used the chitoseal with no problems i eve used with an ACT of 240 it worked like a charm. the secret is to allow the patch to get some blood and apply firm pressure to the site and release the proximal pressure, above the insicion site, after only one minute, but do not apply too much pressure because if you hold too long with a lot of pressure when you release is like releasing a dam and you will have too much pressure into a site that is close only on the outside, if you let the blood come out while you hold pressure there is better exchange of the product with the inside of the artery and better and quiker hemostasis. good luck [email protected] if you have any questions.

:idea: We try to use angioseal whenever we can. It has been great. We used syvek for years, but then changed to Chito and really haven't experienced any problems. What problems have you been having? What is your ACT required before pulling? We have used the new syvek NT and are not super impressed for routine sticks. It seems to be an advantage for large sheath sizes, which we use rarely.