Comparative Safety of Vascular Closure Devices
Authors: Rahman Shah, M. Rehan Khan
Journal: Annals of Internal Medicine (2014)

Letters18 March 2014Comparative Safety of Vascular Closure DevicesRahman Shah, MD and M. Rehan Khan, MDRahman Shah, MDFrom University of Tennessee, Memphis, Tennessee; and Virginia Commonwealth University, Richmond, Virginia.Search for more papers by this author and M. Rehan Khan, MDFrom University of Tennessee, Memphis, Tennessee; and Virginia Commonwealth University, Richmond, Virginia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their recent article Gurm and colleagues (1) repeatedly used the term “benefit of vascular closure devices [VCDs]” for several subgroups, which is misleading. Observational studies cannot provide evidence of cause and effect; they can only suggest some relationship between exposure and outcome (2).Moreover, they concluded that VCD use was associated with decreased vascular complication rates, which contradicts findings of multiple randomized trials (3, 4). Although most of these trials may have been underpowered, several meta-analyses have shown that VCD use did not decrease vascular complication rates (3, 4). Furthermore, VCD use reportedly increased the risk ...References1. Gurm HS, Hosman C, Share D, Moscucci M, Hansen BB; Blue Cross Blue Shield of Michigan Cardiovascular Consortium. Comparative safety of vascular closure devices and manual closure among patients having percutaneous coronary intervention. Ann Intern Med. 2013;159:660-6. [PMID: 24247671] LinkGoogle Scholar2. Pocock SJ, Elbourne DR. Randomized trials or observational tribulations? [Editorial]. N Engl J Med. 2000;342:1907-9. [PMID: 10861329] CrossrefMedlineGoogle Scholar3. Patel MR, Jneid H, Derdeyn CP, Klein LW, Levine GN, Lookstein RA, et al; American Heart Association Diagnostic and Interventional Cardiac Catheterization Committee of the Council on Clinical Cardiology, Council on Cardiovascular Radiology and Intervention, Council on Peripheral Vascular Disease, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council. Arteriotomy closure devices for cardiovascular procedures: a scientific statement from the American Heart Association. Circulation. 2010;122:1882-93. [PMID: 20921445] CrossrefMedlineGoogle Scholar4. Biancari F, D'Andrea V, Di Marco C, Savino G, Tiozzo V, Catania A. Meta-analysis of randomized trials on the efficacy of vascular closure devices after diagnostic angiography and angioplasty. Am Heart J. 2010;159:518-31. [PMID: 20362708] CrossrefMedlineGoogle Scholar5. Rajaram V, Tandon N. Arterial Closure Device Insertion. Accessed at http://emedicine.medscape.com/article/1839487-overview on 23 November 2013. Google Scholar Author, Article, and Disclosure InformationAuthors: Rahman Shah, MD; M. Rehan Khan, MDAffiliations: From University of Tennessee, Memphis, Tennessee; and Virginia Commonwealth University, Richmond, Virginia.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Safety of Vascular Closure Devices and Manual Closure Among Patients Having Percutaneous Coronary Intervention Hitinder S. Gurm , Carrie Hosman , David Share , Mauro Moscucci , and Ben B. Hansen , for the Blue Cross Blue Shield of Michigan Cardiovascular ConsortiumComparative Safety of Vascular Closure Devices Hitinder S. Gurm , Carrie Hosman , and Ben B. Hansen Metrics 18 March 2014Volume 160, Issue 6Page: 438KeywordsHemorrhageHemostasisIschemiaMedical staffObservational studiesRandomized trialsRisk managementSafetySurgeryWalking ePublished: 18 March 2014 Issue Published: 18 March 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...