Arnold Seto, M.D., MPA, FSCAI, chief of cardiology, Long Beach Veterans Affairs Medical Center and director,...
This channel includes news and new technology innovations for devices to help stop bleeding at vascular access sites. These devices can reduce the time to ambulation, allowing same-day procedure discharges. These devices are also used to help reduce bleeding complications and reduce nurse staffing time in post-op care. These include coated or treated bandages to accelerate or augment the clotting cascade, vascular closure devices and compression devices, including radial artery compression systems. Hemostasis is more difficult and time consuming to achieve when larger bore devices are used for structural heart, procedures, endovascular repair devices and hemodynamic support from Impella, TandemHeart and ECMO. The large bore closure segment of the market has been the biggest area of interest in recent years with the rapid expansion of transcatheter structural heart procedures.
The Morristown Medical Center radial lounge uses recliner chairs rather than hospital beds for patients recovering from cath lab procedures using transradial access. The vascular access technique allows patients to immediately walk off the cath lab table following a procedure and they can use the bathroom and walk around during recovery. This is rapidly becoming the preferred access route in cath labs as opposed to the long-used standard of care of femoral artery access in the groin, which required hours of being immobilized in a hospital bed after the procedure, an usually an overnight stay at the hospital.
At Mayo, they have a small, tableside-mounted ultrasound console in the cath labs that is used for both radial and femoral vascular access. Table set up with the patient includes a sterile marker, a hemostat for marking the lower edge of the femoral head using fluoroscopy, a micropunture needle and a still micropunture sheath. Photo and slides courtesy of Yader Sandoval, M.D.