Sep 12 (HeartCenterOnline) - When performing a catheter- based procedure to reopen a clogged artery, physicians use a device called a sheath to enter an artery and allow the catheter to be threaded through to the affected area. Recent research has found that a new device used to remove this sheath may lead to an increased risk of complications after the procedure.

The traditional technique to remove the sheath involves applying pressure while removing the sheath from the artery. It requires that the patient wait four to six hours after the procedure to have the sheath removed (in order to allow the effects of the anticoagulant to pass). The new device (called an arteriotomy closure device, or simply a closure device) seals or stitches the femoral artery as the sheath is removed. This allows the sheath to be removed immediately following the procedure.

According to a September 1, 2001 press release from the American College of Cardiology (ACC), researchers recently compared the rates of procedure complications in 516 patients whose sheaths were removed with a closure device with 5,892 patients whose sheaths were removed traditionally. They found that use of a closure device was associated with higher rates of complications from the procedures.

A catheter-based procedure is a minimally invasive and relatively inexpensive treatment alternative to surgery. During the procedure, a thin tube called a catheter is inserted into a blood vessel through a very small cut made by the physician, then guided up through the blood vessel to the target area (e.g., the heart). The physician tracks the course of the catheter by watching it on a fluoroscope, which displays the blood vessels on a viewing screen. Catheters are often equipped with special devices that allow the physician to open a clogged artery. After the completion of the necessary procedure(s), the catheter is removed. After a closely monitored recovery period, most patients are free to go home within 24 hours.

The risk of complications from catheter-based procedures is very low. Although rare, these risks include:
* Bleeding around the point of puncture
* Abnormal heartbeats (arrhythmia)
* Infection
* Blood clots
* Perforation of a blood vessel, or other damage to the arteries
* Heart attack
* Stroke
* Air embolism
* Death

More information about these devices can be found in the following HeartCenterOnline encyclopedia article: Hemostatic Devices.

More information can also be found in the following HeartCenterOnline topic centers:
The Cardiac Catheterization Center
The Balloon Angiopl asty Center
The Stent Center

Copyright 2001 HeartCenterOnline