SAIMSARA Journal

Machine Generated Science • ISSN 3054-3991

Vascular Closure Devices for Femoral, Large-Bore, and Venous Access Closure: Scoping Review with ☸️SAIMSARA.

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Cardiac & Vascular Health

Issue 1, Volume 1, 2026

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DOI: 10.62487/saimsara7e1ad38d

Editorial note
• Last update: 2026-05-21 11:13:01
What is this paper about
Vascular closure devices are not simply tools to close a puncture site — they are workflow-enabling technologies whose value depends on anatomy, sheath size, imaging guidance, device selection, and bailout readiness. The full evidence map shows where VCDs accelerate hemostasis, ambulation, and discharge, and where complications cluster across femoral, large-bore, venous, TAVR, EVAR, ECMO, PCI, and electrophysiology settings.
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Abstract: To map and synthesize the available structured evidence on vascular closure devices, with emphasis on procedural success, hemostasis, vascular complications, device selection, anatomic and procedural risk factors, imaging guidance, large-bore access closure, venous closure, bailout strategies, and emerging technologies. The review uses 191 references and builds its evidence map from 792 original studies with 6934515 total participants/sample observations (topic-deduplicated ΣN). This scoping review suggests that vascular closure devices function primarily as workflow-enabling technologies that accelerate hemostasis, ambulation, and discharge across coronary, structural heart, electrophysiology, peripheral, aortic, and mechanical circulatory support settings, while their safety profile depends heavily on anatomy, sheath size, and deployment technique rather than device use alone. The most recurrent signal indicates that adverse events cluster around unfavorable access conditions—including small common femoral artery diameter, calcification, puncture depth, and large-bore sheaths—and that ultrasound-guided deployment was associated with reduced complications, with one transfemoral TAVI cohort reporting major VARC-3 complications falling from 1.8% to 0%. Hybrid suture-plus-plug strategies and imaging-guided closure emerged as practical implementations for large-bore access, though bailout pathways remain essential given documented occlusion, embolization, and infection events. Future pragmatic comparative trials with standardized anatomy-based risk stratification and imaging protocols are needed to clarify device-specific noninferiority and to validate emerging bioabsorbable closure technologies.

Keywords: Vascular closure device; Femoral access; Hemostasis; Large-bore arteriotomy; Vascular complications; Transcatheter aortic valve replacement; MANTA device; Suture-mediated closure; Neuroendovascular procedures; Percutaneous decannulation

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