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Network Meta-analysis of Randomized Trials on the Safety of Vascular Closure Devices for Femoral Arterial Puncture Site Haemostasis.

Jiang J, Zou J, Ma H, Jiao Y, Yang H, Zhang X, Miao Y - Sci Rep (2015)

Bottom Line: The safety of vascular closure devices (VCDs) is still debated.Moreover, the use of VCDs reduced the risk of haematomas compared with MC.In conclusion, the use of VCDs is associated with a decreased risk of haematomas, and FemoSeal and AngioSeal appears to be better than MC for reducing the rate of CAVEs.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing 210029, China.

ABSTRACT
The safety of vascular closure devices (VCDs) is still debated. The emergence of more related randomized controlled trials (RCTs) and newer VCDs makes it necessary to further evaluate the safety of VCDs. Relevant RCTs were identified by searching PubMed, EMBASE, Google Scholar and the Cochrane Central Register of Controlled Trials electronic databases updated in December 2014. Traditional and network meta-analyses were conducted to evaluate the rate of combined adverse vascular events (CAVEs) and haematomas by calculating the risk ratios and 95% confidence intervals. Forty RCTs including 16868 patients were included. Traditional meta-analysis demonstrated that there was no significant difference in the rate of CAVEs between all the VCDs and manual compression (MC). Subgroup analysis showed that FemoSeal and VCDs reported after the year 2005 reduced CAVEs. Moreover, the use of VCDs reduced the risk of haematomas compared with MC. Network meta-analysis showed that AngioSeal, which might be the best VCD among all the included VCDs, was associated with reduced rates of both CAVE and haematomas compared with MC. In conclusion, the use of VCDs is associated with a decreased risk of haematomas, and FemoSeal and AngioSeal appears to be better than MC for reducing the rate of CAVEs.

No MeSH data available.


Related in: MedlinePlus

Study flow diagram showing the selection of articles for the meta-analysis.CENTRAL =  Cochrane Central Register of Controlled Trials, RCT = randomized controlled trial.
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f1: Study flow diagram showing the selection of articles for the meta-analysis.CENTRAL =  Cochrane Central Register of Controlled Trials, RCT = randomized controlled trial.

Mentions: The search generated 533 citations. Four hundred and fifty citations were excluded after screening the titles and abstracts. After reading the full text, 41 citations were excluded. The reasons for exclusion were mainly duplicate publication, unrelated topics, retrospective studies, meta-analysis, non-comparative or non-random design studies, and studies without appropriate control groups or outcome measurements. In addition, two eligible trials811 for which the full text was not available were excluded. Two trials1213 were further excluded due to zero events in both arms. Finally, 40 trials671415161718192021222324252627282930313233343536373839404142434445464748495051 were included in this meta-analysis. The screening process is shown in Fig. 1.


Network Meta-analysis of Randomized Trials on the Safety of Vascular Closure Devices for Femoral Arterial Puncture Site Haemostasis.

Jiang J, Zou J, Ma H, Jiao Y, Yang H, Zhang X, Miao Y - Sci Rep (2015)

Study flow diagram showing the selection of articles for the meta-analysis.CENTRAL =  Cochrane Central Register of Controlled Trials, RCT = randomized controlled trial.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562233&req=5

f1: Study flow diagram showing the selection of articles for the meta-analysis.CENTRAL =  Cochrane Central Register of Controlled Trials, RCT = randomized controlled trial.
Mentions: The search generated 533 citations. Four hundred and fifty citations were excluded after screening the titles and abstracts. After reading the full text, 41 citations were excluded. The reasons for exclusion were mainly duplicate publication, unrelated topics, retrospective studies, meta-analysis, non-comparative or non-random design studies, and studies without appropriate control groups or outcome measurements. In addition, two eligible trials811 for which the full text was not available were excluded. Two trials1213 were further excluded due to zero events in both arms. Finally, 40 trials671415161718192021222324252627282930313233343536373839404142434445464748495051 were included in this meta-analysis. The screening process is shown in Fig. 1.

Bottom Line: The safety of vascular closure devices (VCDs) is still debated.Moreover, the use of VCDs reduced the risk of haematomas compared with MC.In conclusion, the use of VCDs is associated with a decreased risk of haematomas, and FemoSeal and AngioSeal appears to be better than MC for reducing the rate of CAVEs.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing 210029, China.

ABSTRACT
The safety of vascular closure devices (VCDs) is still debated. The emergence of more related randomized controlled trials (RCTs) and newer VCDs makes it necessary to further evaluate the safety of VCDs. Relevant RCTs were identified by searching PubMed, EMBASE, Google Scholar and the Cochrane Central Register of Controlled Trials electronic databases updated in December 2014. Traditional and network meta-analyses were conducted to evaluate the rate of combined adverse vascular events (CAVEs) and haematomas by calculating the risk ratios and 95% confidence intervals. Forty RCTs including 16868 patients were included. Traditional meta-analysis demonstrated that there was no significant difference in the rate of CAVEs between all the VCDs and manual compression (MC). Subgroup analysis showed that FemoSeal and VCDs reported after the year 2005 reduced CAVEs. Moreover, the use of VCDs reduced the risk of haematomas compared with MC. Network meta-analysis showed that AngioSeal, which might be the best VCD among all the included VCDs, was associated with reduced rates of both CAVE and haematomas compared with MC. In conclusion, the use of VCDs is associated with a decreased risk of haematomas, and FemoSeal and AngioSeal appears to be better than MC for reducing the rate of CAVEs.

No MeSH data available.


Related in: MedlinePlus