Evidence map›Paper›PMID 36625294›Full record

SynthesisJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists2024

Vascular Closure Devices For Axillary Artery Access: A Systematic Review and Meta-Analysis.

Alex Koziarz, Sean A Kennedy, Ghassan Awad El-Karim, Kong T Tan, George D Oreopoulos, Sanjog Kalra, Christian D Etz, Dheeraj K Rajan, Sebastian Mafeld

Open access · hybridAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Alex KoziarzDepartment of Radiology, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-3914-4373
Sean A KennedyDivision of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
Ghassan Awad El-KarimDivision of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
Kong T TanDivision of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-3468-1313
George D OreopoulosDivision of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
Sanjog KalraPeter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Christian D EtzDepartment of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany.
Dheeraj K RajanDivision of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
Sebastian MafeldDivision of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
University of Toronto · CAUniversity Health Network · CALeipzig Heart Institute · DEMcMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the technical success and complication rates of vascular closure devices (VCDs) in the axillary artery. MATERIALS AND

methodsMEDLINE and Embase were searched independently by two reviewers to identify observational studies from inception through October 2021. The following outcomes were meta-analyzed: technical success, hematoma, dissection, pseudoaneurysm, infection, and local neurological complications. Complications were also graded as mild, moderate, and severe. A logistic regression evaluating the influence of sheath size for the outcome of technical success rate was performed using individual patient-level data.

resultsOf 1496 unique records, 20 observational studies were included, totaling 915 unique arterial access sites. Pooled estimates were as follows: technical success 84.8% (95% confidence interval [CI]: 78%-89.7%, I

conclusionsOff-label use of VCDs in the axillary artery provides an 85% successful closure rate and variable complication rate, depending on the primary procedure and sheath size. Larger sheaths were associated with a lower technical success and greater rate of access-related complications. CLINICAL IMPACT: Safe arterial access is the foundation for arterial intervention. While the common femoral artery is a well established access site, alternative arterial access sites capable of larger sheath sizes are needed in the modern endovascular era. This article provides the largest synthesis to date on the use of vascular closure devices for percutaneous axillary artery access in endovascular intervention. It should serve clinicians with added confidence around this approach in terms of providing a reference for technical success and complications. Clinically, this data is relevant for patient consent purposes as well as for practice quality improvement in setting safety standards for this access site.

Indexed as

Axillary ArteryCatheterization, PeripheralHemostatic TechniquesVascular Closure DevicesAdultAgedEquipment DesignFemaleHemorrhageHumansMaleMiddle AgedObservational Studies as TopicPuncturesRisk AssessmentRisk Factorsaxillary arteryinterventional radiologyvascular closure device

Identifiers

PMID36625294
PMCPMC11408977
OpenAlexW4315436316

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.