Vascular Closure Devices

Vascular closure while introducing Axiostat

Excessive bleeding during or after vascular surgical procedures can lead to severe complications for patients. The traditional method involves manually applying pressure with gauze to control bleeding and initiate haemostasis  after removing the catheter in cardiovascular or endovascular surgeries. This practice, considered the gold standard, applies to both femoral and radial access sites.

However, there are a few drawbacks of manually compressing bleeding to halt it

  • It can take a lot of time to stop the bleeding via simple manual pressure via gauze
  • The procedure takes up a lot of time of the surgical staff
  • Application of pressure can lead to pain and discomfort for the patients
  • It can also lead to long hours of costly hospital time spent under observation (almost 8 hours or more of bed rest in the recovery room)

Vascular closure devices (VCD) are products that can be used to stop the bleeding at the arterial site after the catheter is removed4. These can be of various types, for example, sutures, clips, dressing material, biomaterial-based dressings, and more.

Advantages and Limitations of using VCDs:

The use of VCDs significantly shortens the time-to-ambulation (TTA) and time-to-haemostasis (TTH). However, the incidence of vascular access site complications (VASCs) remains between 5% and 12%. 

The technical failure of VCDs is around 1.1–8.7%. Therefore, except in one-day procedures, the use of VCDs is still controversial, and haemostasis by manual compression still holds a key role in the case of introducers not exceeding 8 Fr in calibre with an underlying bone structure to adequately compress the access site.5

Use of Axiostat for Vascular Procedure

Axiostat is a biomaterial-based haemostatic dressing that helps in stopping bleeding at surgical sites as well as for accidents and injuries. It is a chitosan-based bioactive haemostatic dressing that works based on charge-based Protonated Bio adhesive Technology®. It essentially forms a mechanical barrier at the site of bleeding.

How does Axiostat stop bleeding?

At first, the product needs to be applied over the puncture site. When it is applied via minimal compression at the site, it creates a temporary barrier to stop bleeding.

The chitosan in the Axiostat is positively charged and the components in the blood are negatively charged. As such, a strong mechanical seal is formed at the puncture site that prevents leakage of blood. The Axiostat haemostasis mechanism involves four steps6:

Step 1: Charge based adhesion between blood components and Axiostat

Step 2: Platelet Activation via Toll-like receptors (TLR)

Step 3: Clotting cascade activation

Step 4: Fibrin Microthrombi plug formation at the bleeding site

The use of Axiostat for vascular closure at radial and femoral puncture sites after the catheter is removed offers a variety of advantages7.

  • It presents a sterilized environment for haemostasis to occur.
  • Axiostat is useful in cases of persons using blood thinners to effectively stop bleeding
  • It stops moderate to even severe bleeding within a few minutes of its application
  • The dressing is highly flexible and can be used on both of its surfaces
  • It is cut up and folded as per the surgeon’s requirement for the puncture
  • The product does not pose any risk for emboli and can be used on all sheath sizes
  • It is easily and painlessly removed by irrigating with salt water

Axiostat allows for much shorter haemostasis time (reduction by almost 80 %) compared to traditional compression by gauze. This helps in reducing the time required for recovery, ensuring that the patient can go home quicker. It is recommended for use in femoral interventional cardiology procedures, interventional radiology procedures, and any type of vascular interventional procedures.

To know more about Axiostat or to schedule a demonstration, you can reach out to us at info@axiobio.com