Abstract 12334: Venous Access Site Closure With Vascular Closure Device versus Manual Compression in Patients Undergoing Catheter Ablation or Left Atrial Appendage Occlusion Under Uninterrupted Anticoagulation: A Multi-Center Experience on Efficacy and Complications

BackgroundManual compression (MC), widely used to achieve venous access hemostasis, needs prolonged immobilization and extended time-to-hemostasis. Besides, urinary catheterization is required in all cases because of the mandatory immobilization. Vascular closure devices (VCD) have been reported to have significantly shorter time to hemostasis and ambulation in arterial access-site management.ObjectiveTo evaluate the safety and efficacy as well as rate of urinary tract complications in patients receiving MC vs VCD for venous access site closure.MethodsA total of 803 consecutive patients undergoing catheter ablation or left atrial appendage closure were classified into the VCD (n=304) and the MC (n=499) group, based on the methods used for hemostasis at the venous access site. Foley catheter was used for bladder-emptying in all MC cases and 15 VCD patients. At one site, VCD group patients with experience of manual compression in prior ablations were asked to describe their overall satisfaction level after comparing the past experience with the present.ResultsHemostasis was achieved effectively in both populations. No VCD cases required >2 hours bedrest whereas 7 (1.4%) patients in the MC group needed prolonged immobilization (p=0.04). Significantly higher incidence of access-site hematoma (p=0.004) and urinary complications (p