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

Published on:2016-11-28   Views:191


The safety of vascular closure devices(VCDs) is still debated. The emergence of more related randomized controlledtrials (RCTs) and newer VCDs makes it necessary to further evaluate the safetyof VCDs. Relevant RCTs were identified by searching PubMed, EMBASE, GoogleScholar and the Cochrane Central Register of Controlled Trials electronicdatabases updated in December 2014. Traditional and network meta-analyses wereconducted to evaluate the rate of combined adverse vascular events (CAVEs) andhaematomas by calculating the risk ratios and 95% confidence intervals. FortyRCTs including 16868 patients were included. Traditional meta-analysisdemonstrated that there was no significant difference in the rate of CAVEsbetween all the VCDs and manual compression (MC). Subgroup analysis showed thatFemoSeal and VCDs reported after the year 2005 reduced CAVEs. Moreover, the useof VCDs reduced the risk of haematomas compared with MC. Network meta-analysisshowed 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 ofhaematomas, and FemoSeal and AngioSeal appears to be better than MC forreducing the rate of CAVEs.