Study Shows Improved Patient Comfort With Vascular Closure Device
March 10, 2011 – The first study to compare pain associated with deployment of different vascular closure devices (VCD) as the primary endpoint has been published in the Journal of NeuroInterventional Surgery. The trial compared the discomfort associated with the Mynx 5 French VCD, from AccessClosure, to the Angio-Seal Evolution Device.
Both pain at closure and the pain increase from baseline to closure were significantly higher in patients undergoing closure with the Angio-Seal Evolution device (p=0.009 and 0.002, respectively). There was no difference in the rate of closure success or closure complications between the devices.
"This is an important study for physicians and patients,'' said Gregory D. Casciaro, president and CEO of AccessClosure. "The study scientifically examined whether the Mynx device reduced the pain associated with arteriotomy closure seen with the Angio-Seal Evolution device and provides an evidence-based understanding that will help guide choice about VCD options."
The Institutional Review Board-approved study enrolled 128 patients based on power analyses with the intention of performing preliminary statistical analysis following enrollment of 64 patients (32 patients in each arm). Patients, nurses administering a commonly utilized, well-validated visual analog scale (VAS) to assess patient pain, and study coordinators were blinded to the VCD treatment. The primary endpoint was defined as the change in pain from baseline (pre-closure) to post-closure, assessed by the VAS. The patient's reporting of the most painful part of the procedure from a multiple-choice selection was a secondary endpoint along with major and minor adverse events associated with VCD and closure.
The reduction in pain favoring the Mynx device compared to the Angio-Seal Evolution device was highly significant for both primary and secondary endpoints. More than twice as many patients undergoing closure by Angio-Seal as those undergoing Mynx closure reported the most painful part of the procedure to be VCD deployment (88 percent vs. 34 percent, p<0.001).
The large difference in pain experienced between patients was hypothesized to be secondary to the presence or absence of compression elements within the devices. No major or minor adverse events were reported in patients undergoing either procedure, although the study was not powered to detect a difference in adverse complications.
"Patient comfort is an important aspect in selecting a vascular closure device and every step taken to improve the patient's experience is a step in the right direction," said J. Mocco, M.D., department of neurosurgery, University of Florida College of Medicine, and co-author of the study.
The Mynx device is indicated for use to seal femoral arterial access sites while reducing times to hemostasis and ambulation in patients who have undergone diagnostic or interventional endovascular procedures utilizing a 5, 6 or 7 French procedural sheath. It has not been approved for the reduction of pain in VCD procedures.
For more information: www.accessclosure.com