Vascular access site complications
following catheterization procedures are one of the most frequent causes
of morbidity. Manual compression is the most commonly followed
procedure in achieving hemostasis of the arterial site. However manual
compression frequently requires anticoagulation, prolonged bed rest and
patient discomfort, along with time constraints for healthcare
providers. Vascular closure devices (VCDs) have emerged as an
alternative to mechanical compression in order to reduce the hemostasis
that includes biodegradable plugs, sutures, staples or ultrasound.
Vascular closure devices offer advantages
over manual compression in terms of patient easiness, reduction in
ambulation period, and clotting time, however complications related to
the femoral site are still present. The main goal is to prevent vascular
access site complications, and achieving rapid hemostasis. These are
effective and well tolerated in the procedures that do not use anti
coagulation and in diagnostic procedures. Due to the several advantages
of VCDs over the traditional mode of hemostasis, they are widely used in
both diagnostic and interventional procedures. Various types of
vascular closures are developed over a period of time that incorporate
different mechanisms. The safety of VCDs remains in uncertainty as they
may rise the risk of infection and leg ischemia. The benefits conveyed
by VCDs are supposed to be costly; particularly in case of invasive
VCDs. The increasing desire for radial access in the coronary
procedures, is a major concern for VCDs market, as the radial artery can
be closed more easily, thus opposing the need for invasive VCDs. This
could also result in a swing from invasive VCDs to the low-priced manual
compression device.
The inherent vascular closure device
market has been segmented by types of devices and geography. The types
of devices include the manual compression and vascular closure devices.
The VCDs are of two types: active and passive. Passive VCDs provide
enhanced hemostasis with mechanical compression but do not give prompt
hemostasis. The passive VCDs are further classified as hemostatic
pad,(Chito seal, CloSur pad, Neptune pad, Syvek patch and Dstat), and
compression devices (femostop system, compass system, clamp ease,
safeguard dressing and x press device). Active VCDs are categorized as
suture devices, clips, polyglycolic acid devices, and collagen plug
devices. Collagen plug devices consist of two type’s angioseal and
vasoseal whereas polyglycolic acid consists of mynx and exoseal. Based
on the geography the VCDs can be segmented into North America, Europe,
Asia-Pacific, Latin America, and Middle East & Africa.
An increasing range of endovascular
procedures, preference for minimal invasive surgeries, decrease in the
rate of vascular complications after the use of VCDs (angioseal and
perclose), increasing catheterization related procedures, reimbursement
for diagnostic procedures carried out, ease in usage and quick
hemostatic properties of VCDs, and comfort provided to the patients are
the major factors responsible to drive the market of VCDs. The
increasing cost of implantable vascular devices, complications
associated with VCD, low adoption of advance technology in the emerging
countries, the rising incidences of leg ischemia, growing infection has
resulted in decline in VCDs market. The number of peripheral vascular
procedures is increasing yearly, leading to sustainment and
stabilization of the market of invasive VCDs.
The major players in VCDs are St. Jude Medical, Morris Innovative Research, Vascular Solutions,
Abbott Laboratories, Cardiva Medical,
Cardinal Health, Marine Polymer Technologies, Terumo Corporation,
Advanced Vascular Dynamics, Benrikal Services, Scion BioMedical. St
Jude’s is the leader in the global vascular closure devices market.
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