Closure device's being used in Cath Labs

Editorial Team / Admin · Mar 31, 2012

Our MDs mainly use Clo-Sur P.A.D.s and the occ. AngioSeal.

We have found using the pads is more cost-effective, has a less steep learning curve for the noobs and leaves nothing in the body.

We're also doing more radial cases, which the Fellows like, and using the TR Bands for closure there.

yvfair · Mar 31, 2012

Our cath lab uses Angioseal most of the time!! It's very successful. Perclose and Starclose have been used before but there is always bleeding involved.

Tell your cath lab to sick with Angioseal or go radial access and use the TR bands which is very successful

CarolMarie · Apr 1, 2012

We too are having bleeding problems with the StarClose and Perclose ProGlide. We are going back to the AngioSeals, but the Dr.'s also want to start using the newest product Arstasis. It is getting expensive having all of these products on the shelf. We have done a few radials, do you guys have a SiteRite ultrasound to help with access? We are a small Cath Lab, but do lot's of peripheral fixes also. Thanks

CCL RN, RN · Apr 2, 2012

We almost NEVER use closure devices. For just about everything, we use our hands....

If the very rare situation arises where we use a closure device, it would be an angioseal.

In the past year, we've used one (1) closure device.

Everything else has been manual pressure.

CarolMarie · Apr 3, 2012

Wow, I'm surprised no closure devices at all in your lab. Do you use things like Syvek's or Clo-Sur pad to control bleeding? For those using radial access do you use a SiteRite or SonoSite Ultrasound?

CCL RN, RN · Apr 4, 2012

No, and no. And we have some who use the radial approach for STEMIs. They don't need a site rite that's for sure. My last lab didn't use a site rite for radial approach either, or use any pads. Must be a regional thing.

I don't understand why anyone would use/need a pad to control bleeding. My hands control the bleeding. There's nothing that compares to a manual hold.

nurseCPOE · Apr 5, 2012

Our MDs use Angioseal, but a few love the Mynx system. On most cases however we just use our hands. We have one MD that comes in from another hospital to cover call, and he LOVES radials. That's all he will do anymore, but he's the only one.

nimiroiRN · Apr 9, 2012

we use angioseal but not all MDs uses it, they prefer manual pressure coz its much more reliable and cost effective. TR band is doing its thing during radial approach and cases from the radial is increasing, i guess its much more comfortble for the pt.

Flyboy17 · Apr 9, 2012

Both or our docs prefer Perclose for all closable groin cases. We hardly ever have a failure and when we do it is always operator error. The Perclose is a great system however it does require more training. Once placed properly it is hard to beat. For our Radial cases we use TR-bands and have love them.

Jonathan RN

turnforthenurse, MSN, NP · Apr 22, 2012

It all depends on the physician. I've seen Angioseal, Perclose and Mynx...if we're pulling sheaths on the floor, we will use Syvek + manual pressure. Another physicians wants the Syvek + a butterfly dressing and tensoplast dressings (which I don't like because there is so much "dressing" there it makes it hard to feel for a hematoma!). Our cath lab RN's are now saying that some of the physicians are now using D-stat which they do not like and I'm not sure why. The D-stat is something new. Another cardiologist also prefers the radial approach so usually his patients will come back to the floor with a TR band.

90orLess · May 8, 2012

We use Angio-Seal, Perclose, and Starclose on a regular basis with great success. At our facility, the physicians deploy the closure device, and they have a fairly low failure rate. I think it's a user failure if your having a low success rate like that. We also use a D-Stat Dry thrombin pad I'd a Safeguard device for oozing, or the Femostop for bleeding.