Application effect of Perclose ProGlide vascular closure system in transcatheter aortic valve replacement via femoral artery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CUI Hongzhan , ZHANG Hang , AN Jinghui , LIU Su , SHI Fengwu ,  MA Qianli

Department of Cardiac Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, P. R. China;

Corresponding?author：

MA Qianli, Email: ql111190828@sina.com

Keywords：

Transcatheter aortic valve replacement; peripheral vessels; vascular closure device; minimally invasive surgery; complications; puncture

DOI：

10.7507/1007-4848.202604084

Video：

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Objective To evaluate the efficacy and safety of the Perclose ProGlide vascular closure system for femoral artery access site closure in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). Methods We retrospectively analyzed the perioperative data of patients who underwent transfemoral TAVR at the Second Hospital of Hebei Medical University from January 2023 to September 2025. Based on the closure method for the main arterial access site, patients were divided into a surgical group (surgical cut-down and repair) and a ProGlide group (pre-closure with the ProGlide system). The effectiveness of access site closure and clinical outcomes were compared between the two groups. Results A total of 413 patients were included, with 183 in the surgical group and 230 in the ProGlide group. The surgical group consisted of 112 males and 71 females, with a mean age of (68.2±6.3) years. The ProGlide group included 141 males and 89 females, with a mean age of (69.2±5.2) years. No mortality was observed in either group. In the ProGlide group, immediate hemostasis was successfully achieved with two ProGlide devices in 220 (95.7%) patients. An additional 10 patients required a third device to achieve hemostasis. At 6 hours post-procedure, no active bleeding was observed. Subcutaneous hematoma occurred in 5 patients, all of whom resolved after 10 minutes of manual compression. The final hemostasis success rate was 97.8% for the ProGlide group. In the surgical group, no active bleeding or subcutaneous hematoma was observed at 6 hours post-procedure, yielding a hemostasis success rate of 100.0%. Poor wound healing occurred in 28 patients and access site-related nerve injury in 41 patients in the surgical group. In contrast, no patients of poor wound healing or nerve injury were reported in the ProGlide group. No major vascular complications occurred in either group. At 6 hours post-procedure, the Kolcaba Comfort Scale score was significantly higher in the ProGlide group than that in the surgical group (P<0.001). Compared to the surgical group, the ProGlide group had significantly shorter procedure times and postoperative hospital stays (both P<0.001). Conclusion The Perclose ProGlide vascular closure system provides effective closure for the main femoral access site in transfemoral TAVR. Compared with the conventional surgical cut-down method, it offers the advantages of being less invasive, enabling faster recovery, and providing greater procedural convenience, making it a valuable technique worthy of broader clinical adoption.

1.	張秀, 羅澤汝心, 王渝強, 等. 經導管主動脈瓣置換術老年衰弱患者圍手術期康復護理最新證據[J/OL]. 中國胸心血管外科臨床雜志, 2026. DOI: 10.7507/1007-4848.202602053.Zhang X, Luo ZRX, Wang YQ, et al. Current evidence of perioperative rehabilitation nursing in frail elderly patientsundergoing transcatheter aortic valve replacement[J/OL]. Chin J Clin Thorac Cardiovasc Surg, 2026. DOI: 10.7507/1007-4848.202602053.
2.	國家放射與治療臨床醫學研究中心, 蘇州工業園區東方華夏心血管健康研究院. 經導管主動脈瓣置換術中國專家共識 (2025 版)[J]. 中國介入心臟病學雜志, 2025, 33(12): 661-674.National Clinical Research Center for Interventional Medicine, China Heart House. Chinese expert consensus on transcatheter aortic valve replacement (2025)[J]. Chin J Interv Cardiol, 2025, 33(12): 661-674.
3.	Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS guidelines for the management of valvular heart disease[J]. Eur Heart J, 2025, 46(44): 4635-4736.
4.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease[J]. Eur Heart J, 2022, 43(7): 561-632.
5.	黃岑, 李玲利, 鄭明霞, 等. 經導管主動脈瓣置換術后患者早期出院的研究進展[J]. 華西醫學, 2025, 40(10): 1683-1689.Huang C, Li LL, Zheng MX, et al. Research progress on early discharge of patients after transcatheter aortic valve replacement[J]. West China Med J, 2025, 40(10): 1683-1689.
6.	中國醫師協會心血管內科醫師分會結構性心臟病學組, 周達新, 吳永健. 單純主動脈瓣反流經股動脈主動脈瓣置換中國專家共識 2023[J]. 中國介入心臟病學雜志, 2023, 31(11): 801-809.Structural Heart Disease Group of Cardiologist Branch of Chinese Medical Doctor Association, Zhou DX, Wu YJ. 2023 Chinese expert consensus on transfemoral transcatheter aortic valve replacement for isolated aortic regurgitation[J]. Chin J Interv Cardiol, 2023, 31(11): 801-809.
7.	Deshmukh A, Ghannam M, Cunnane R, et al. Double ProGlide preclose technique for vascular access closure after leadless pacemaker implantation[J]. J Interv Card Electrophysiol, 2022, 63(2): 341-343.
8.	崔姣姣, 梁善福, 張申偉, 等. 經導管主動脈瓣置換術對二葉式主動脈瓣重度狹窄患者血流動力學、心室逆重構及心肌損傷的影響[J]. 中國心血管雜志, 2025, 30(6): 685-691.Cui JJ, Liang SF, Zhang SW, et al. Impact of TAVR on hemodynamics, ventricular reverse remodeling and myocardial injury inpatients with severe bicuspid aortic valve stenosis[J]. Chin J Cardiovasc Med, 2025, 30(6): 685-691.
9.	薛武超, 劉洋, 金屏, 等. 球囊后擴張對 TAVR 手術患者心臟傳導影響的回顧性隊列研究[J]. 中國胸心血管外科臨床雜志, 2025, 32(12): 1716-1721.Xue WC, Liu Y, Jin P, et al. Retrospective cohort study on the effect of post-dilation on cardiac conduction in patients undergoing TAVR[J]. Chin J Clin Thorac Cardiovasc Surg, 2025, 32(12): 1716-1721.
10.	賴叔意, 朱雪夢, 林丹丹, 等. 醫護患三方視角下經導管主動脈瓣置換術圍手術期護理質量評價指標的質性研究[J/OL]. 溫州醫科大學學報, 2026.Lai SY, Zhu XM, Lin DD, et al. A qualitative study on the evaluation indicators of perioperative nursing quality fortranscatheter aortic valve replacement from the perspectives of physicians, nurses, and patients[J/OL]. J Wenzhou Med Univ, 2026.
11.	Melloni A, Grandi A, Spelta S, et al. Outcomes of routine use of percutaneous access with large-bore introducer sheaths (>21F outer diameter) during endovascular aneurysm repair[J]. J Vasc Surg, 2021, 73(1): 81-91.
12.	施燾, 房杰, 張永保, 等. 血管縫合器系統預縫合技術處理大口徑動脈鞘穿刺點的有效性及安全性[J]. 血管與腔內血管外科雜志, 2023, 9(8): 905-908, 926.Shi T, Fang J, Zhang YB, et al. Effectiveness and safety of the preclose technique of vascular suture system in the treatment of large aperture arterial sheath puncture points[J]. J Vasc Endovasc Surg, 2023, 9(8): 905-908, 926.
13.	Matta A, Canitrot R, Nader V, et al. Prevalence of posttranscatheter aortic valve implantation vascular complications in real life[J/OL]. J Interv Cardiol, 2021: 5563486. DOI: 10.1155/2021/5563486.
14.	Ismail M, Berberoglu Aydin DM, Lee JS, et al. Femoral vessel cannulation strategies in minimally invasive cardiac surgery: single Perclose ProGlide versus open cut-down[J/OL]. Eur J Cardiothorac Surg, 2025, 67(4): ezaf118. DOI: 10.1093/ejcts/ezaf118.
15.	Li R, Wang L, Liu Q, et al. Comparative study of single- versus double-ProGlide device strategy for access site closure of transfemoral transcatheter aortic valve replacement[J]. Catheter Cardiovasc Interv, 2025, 106(3): 1639-1649.
16.	Bechara CF, Barshes NR, Pisimisis G, et al. Predicting the learning curve and failures of total percutaneous endovascular aortic aneurysm repair[J]. J Vasc Surg, 2013, 57(1): 72-76.
17.	Varis E, Gurbuz DC. Learning curve of perclose ProGlide utilization during percutaneous coronary intervention[J/OL]. Cureus, 2023, 15(4): e38155. DOI: 10.7759/cureus.38155.
18.	賈昊, 陸樹洋, 孫勇新, 等. 血管閉合器的應用現狀和進展[J]. 中國胸心血管外科臨床雜志, 2023, 30(12): 1791-1796.Jia H, Lu SY, Sun YX, et al. Application status and research progress of vascular closure devices[J]. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(12): 1791-1796.

1. 張秀, 羅澤汝心, 王渝強, 等. 經導管主動脈瓣置換術老年衰弱患者圍手術期康復護理最新證據[J/OL]. 中國胸心血管外科臨床雜志, 2026. DOI: 10.7507/1007-4848.202602053.Zhang X, Luo ZRX, Wang YQ, et al. Current evidence of perioperative rehabilitation nursing in frail elderly patientsundergoing transcatheter aortic valve replacement[J/OL]. Chin J Clin Thorac Cardiovasc Surg, 2026. DOI: 10.7507/1007-4848.202602053.
2. 國家放射與治療臨床醫學研究中心, 蘇州工業園區東方華夏心血管健康研究院. 經導管主動脈瓣置換術中國專家共識 (2025 版)[J]. 中國介入心臟病學雜志, 2025, 33(12): 661-674.National Clinical Research Center for Interventional Medicine, China Heart House. Chinese expert consensus on transcatheter aortic valve replacement (2025)[J]. Chin J Interv Cardiol, 2025, 33(12): 661-674.
3. Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS guidelines for the management of valvular heart disease[J]. Eur Heart J, 2025, 46(44): 4635-4736.
4. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease[J]. Eur Heart J, 2022, 43(7): 561-632.
5. 黃岑, 李玲利, 鄭明霞, 等. 經導管主動脈瓣置換術后患者早期出院的研究進展[J]. 華西醫學, 2025, 40(10): 1683-1689.Huang C, Li LL, Zheng MX, et al. Research progress on early discharge of patients after transcatheter aortic valve replacement[J]. West China Med J, 2025, 40(10): 1683-1689.
6. 中國醫師協會心血管內科醫師分會結構性心臟病學組, 周達新, 吳永健. 單純主動脈瓣反流經股動脈主動脈瓣置換中國專家共識 2023[J]. 中國介入心臟病學雜志, 2023, 31(11): 801-809.Structural Heart Disease Group of Cardiologist Branch of Chinese Medical Doctor Association, Zhou DX, Wu YJ. 2023 Chinese expert consensus on transfemoral transcatheter aortic valve replacement for isolated aortic regurgitation[J]. Chin J Interv Cardiol, 2023, 31(11): 801-809.
7. Deshmukh A, Ghannam M, Cunnane R, et al. Double ProGlide preclose technique for vascular access closure after leadless pacemaker implantation[J]. J Interv Card Electrophysiol, 2022, 63(2): 341-343.
8. 崔姣姣, 梁善福, 張申偉, 等. 經導管主動脈瓣置換術對二葉式主動脈瓣重度狹窄患者血流動力學、心室逆重構及心肌損傷的影響[J]. 中國心血管雜志, 2025, 30(6): 685-691.Cui JJ, Liang SF, Zhang SW, et al. Impact of TAVR on hemodynamics, ventricular reverse remodeling and myocardial injury inpatients with severe bicuspid aortic valve stenosis[J]. Chin J Cardiovasc Med, 2025, 30(6): 685-691.
9. 薛武超, 劉洋, 金屏, 等. 球囊后擴張對 TAVR 手術患者心臟傳導影響的回顧性隊列研究[J]. 中國胸心血管外科臨床雜志, 2025, 32(12): 1716-1721.Xue WC, Liu Y, Jin P, et al. Retrospective cohort study on the effect of post-dilation on cardiac conduction in patients undergoing TAVR[J]. Chin J Clin Thorac Cardiovasc Surg, 2025, 32(12): 1716-1721.
10. 賴叔意, 朱雪夢, 林丹丹, 等. 醫護患三方視角下經導管主動脈瓣置換術圍手術期護理質量評價指標的質性研究[J/OL]. 溫州醫科大學學報, 2026.Lai SY, Zhu XM, Lin DD, et al. A qualitative study on the evaluation indicators of perioperative nursing quality fortranscatheter aortic valve replacement from the perspectives of physicians, nurses, and patients[J/OL]. J Wenzhou Med Univ, 2026.
11. Melloni A, Grandi A, Spelta S, et al. Outcomes of routine use of percutaneous access with large-bore introducer sheaths (>21F outer diameter) during endovascular aneurysm repair[J]. J Vasc Surg, 2021, 73(1): 81-91.
12. 施燾, 房杰, 張永保, 等. 血管縫合器系統預縫合技術處理大口徑動脈鞘穿刺點的有效性及安全性[J]. 血管與腔內血管外科雜志, 2023, 9(8): 905-908, 926.Shi T, Fang J, Zhang YB, et al. Effectiveness and safety of the preclose technique of vascular suture system in the treatment of large aperture arterial sheath puncture points[J]. J Vasc Endovasc Surg, 2023, 9(8): 905-908, 926.
13. Matta A, Canitrot R, Nader V, et al. Prevalence of posttranscatheter aortic valve implantation vascular complications in real life[J/OL]. J Interv Cardiol, 2021: 5563486. DOI: 10.1155/2021/5563486.
14. Ismail M, Berberoglu Aydin DM, Lee JS, et al. Femoral vessel cannulation strategies in minimally invasive cardiac surgery: single Perclose ProGlide versus open cut-down[J/OL]. Eur J Cardiothorac Surg, 2025, 67(4): ezaf118. DOI: 10.1093/ejcts/ezaf118.
15. Li R, Wang L, Liu Q, et al. Comparative study of single- versus double-ProGlide device strategy for access site closure of transfemoral transcatheter aortic valve replacement[J]. Catheter Cardiovasc Interv, 2025, 106(3): 1639-1649.
16. Bechara CF, Barshes NR, Pisimisis G, et al. Predicting the learning curve and failures of total percutaneous endovascular aortic aneurysm repair[J]. J Vasc Surg, 2013, 57(1): 72-76.
17. Varis E, Gurbuz DC. Learning curve of perclose ProGlide utilization during percutaneous coronary intervention[J/OL]. Cureus, 2023, 15(4): e38155. DOI: 10.7759/cureus.38155.
18. 賈昊, 陸樹洋, 孫勇新, 等. 血管閉合器的應用現狀和進展[J]. 中國胸心血管外科臨床雜志, 2023, 30(12): 1791-1796.Jia H, Lu SY, Sun YX, et al. Application status and research progress of vascular closure devices[J]. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(12): 1791-1796.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesApplication effect of Perclose ProGlide vascular closure system in transcatheter aortic valve replacement via femoral artery

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