***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The RESPECT trial was aim ed at evaluating safety/efficacy of a new extravascular closure system in diagnostic ( Dx ) and interventional ( Ix ) procedures performed through 6 or 7 Fr introducer sheaths . BACKGROUND Although vascular closure devices ( VCDs ) have been available for two decades , manual compression ( MC ) remains the st and ard of care in many institutions . VCDs have not been shown to have greater safety than MC . METHODS The RESPECT trial was a multicenter , r and omized comparison of the Vascade VCD ( Cardiva Medical , Inc ) versus MC in Dx and Ix patients undergoing femoral access . Endpoints included time to hemostasis ( TTH ) , time to ambulation ( TTA ) , time to discharge eligibility ( TTDe ) , device and procedure success , major and minor complications . Subjects were r and omized 2:1 ( Vascade vs MC ) . RESULTS A total of 420 patients were enrolled ( 211 Dx , 209 Ix ) . Mean age was 62 ± 11 years and 29 % were female . For Ix Vascade/MC patients , 77%/69 % received bivalirudin , 27%/26 % received heparin , and 8%/3 % received glycoprotein IIb/IIIa inhibitors , respectively . Patients were followed for 30 ± 7 days . A total of 415 subjects ( 98.8 % ) completed follow-up . TTH was 3.0 minutes ( range , 0.6 - 31.6 minutes ) for Vascade vs 20.0 minutes ( range , 0.0 - 97.0 minutes ) for MC ; TTA was 3.2 hours ( range , 1.0 - 78.0 hours ) for Vascade vs. 5.2 hours ( range , 1.7 - 22.8 hours ) for MC ; and TTDe was 3.6 hours ( range , 1.4 - 78.4 hours ) for Vascade vs. 5.7 hours ( range , 2.2 - 23.2 hours ) for MC . Device and procedure success rates were 98 % for Vascade and 100 % for MC . Minor events were 1.1 % for Vascade and 7 % for MC . No major access-site related complications were reported in either arm . CONCLUSION Despite high percentage of bivalirudin use , there were no major access-site related complications in either arm . Vascade use reduced rates of minor access-site related complications , and significantly shortened TTH , TTA , and TTDe compared to MC OBJECTIVE The first multicenter r and omized controlled trial was design ed and conducted to assess the safety and effectiveness of  totally percutaneous endovascular aortic aneurysm repair ( PEVAR )  with use of a 21F endovascular stent graft system and either an 8 F or 10 F suture-mediated closure system ( the PEVAR trial , NCT01070069 ) . A noninferiority trial design was chosen to compare percutaneous access with st and ard open femoral exposure . METHODS Between 2010 and 2012 , 20 U.S. institutions participated in a prospect i ve , Food and Drug Administration-approved r and omized trial to evaluate percutaneous femoral artery access and closure by a " preclose " technique in conjunction with endovascular abdominal aortic aneurysm repair . A total of 151 patients were allocated by a 2:1 design to percutaneous access/closure ( n = 101 ) or open femoral exposure ( n = 50 [ FE ] ) . PEVAR procedures were performed with either the 8 F Perclose ProGlide ( n = 50 [ PG ] ) or the 10 F Prostar XL ( n = 51 [ PS ] ) closure devices . All endovascular abdominal aortic aneurysm repair procedures were performed with the Endologix 21 F profile ( outer diameter ) sheath-based system . Patients were screened by computed tomography with three-dimensional reconstruction and independent physician review for anatomic suitability and adequate femoral artery anatomy for percutaneous access . The primary trial end point ( treatment success ) was defined as procedural technical success and absence of major adverse events and vascular complications at 30 days . An independent access closure sub study evaluated major access-related complications . Clinical utility and procedural outcomes , ankle-brachial index , blood laboratory analyses , and quality of life were also evaluated with continuing follow-up to 6 months . RESULTS Baseline characteristics were similar among groups . Procedural technical success was 94 % ( PG ) , 88 % ( PS ) , and 98 % ( FE ) . One-month primary treatment success was 88 % ( PG ) , 78 % ( PS ) , and 78 % ( FE ) , demonstrating noninferiority vs FE for PG ( P = .004 ) but not for PS ( P = .102 ) . Failure rates in the access closure sub study analyses demonstrated noninferiority of PG ( 6 % ; P = .005 ) , but not of PS ( 12 % ; P = .100 ) , vs FE ( 10 % ) . Compared with FE , PG and PS yielded significantly shorter times to hemostasis and procedure completion and favorable trends in blood loss , groin pain , and overall quality of life . Initial noninferiority test results persist to 6 months , and no aneurysm rupture , conversion to open repair , device migration , or stent graft occlusion occurred . CONCLUSIONS Among trained operators , PEVAR with an adjunctive preclose technique using the ProGlide closure device is safe and effective , with minimal access-related complications , and it is noninferior to st and ard open femoral exposure . Training , experience , and careful application of the preclose technique are of paramount importance in ensuring successful , sustainable outcomes Objectives : To compare Angio‐Seal ( AS ) and StarClose ( SC ) and manual compression ( MC ) on efficacy of hemostasis , complication rate , safety of early mobilization , and patient comfort . Background : Closure of the femoral artery after cardiac catheterization can be obtained through different methods . Today , physicians can choose from a number of different devices to achieve arterial closure . Methods : In a prospect i ve trial 450 patients were r and omized to AS , SC , or MC . Patients were mobilized 1 to 2 hr after device placement , and 6 hr after MC . Data were collected during hospital admission and by telephone at one month after hospital discharge . Results : Devices were used in 138/150 allocated to AS and 124/150 allocated to SC patients ( 92 % vs. 83 % , P = 0.015 ) Patients with MC experienced more pain during sheath removal than patients receiving a device , and rated their period of bed rest as less comfortable . Oozing and need for pressure b and age at the puncture site were observed in 37 AS patients and 57 SC patients ( 25 % vs. 38 % , P = 0.002 ) . Hematoma occurred in 15 AS patients , in 17 SC patients , and in 14 MC patients ( 11 vs. 14 vs. 9 % , ns ) . Conclusion : There is no difference in safety between the three methods of arterial closure . SC was more often not used or successfully deployed . SC patients more often had continuing oozing . On patient comfort , closure devices performed better than MC . Early ambulation in patients with a closure device is safe . AS is the preferred method of arterial closure after cardiac catheterization . © 2008 Wiley‐Liss , BACKGROUND Collagen-based vascular closure devices ( VCD ) are commonly used after catheterization with femoral access . However , data about complication rates due to the utilization of VCDs in patients with known peripheral artery disease ( PAD ) of the lower limbs are inconsistent and patients with significant PAD are excluded in most VCD trials . In this study , we aim ed to assess complication rates of collagen-based VCDs in patients with significant PAD . METHODS Patients with significant PAD treated with a VCD ( Angio-Seal ; St Jude Medical , Inc ) after percutaneous therapeutic interventions of lower extremities were included in this study . Significant PAD was defined as Fontaine ≥2b  . In-hospital complications ( bleeding , spurious aneurysm , vessel occlusion , dissection , surgical repair , vasovagal reaction ) were recorded . RESULTS A total of 121 patients ( 64.6 ± 11.3 years , 77 % male ) were included . PAD stage IIb was present in 99 patients ( stage III in 8 patients , stage IV in 14 patients ) . A total of 112 treatments ( 93.3 % ) processed without complications ( major complication rate , 1.7 % ; minor complication rate , 5.0 % ) . There was a trend toward higher prevalence of complications with increasing size of closure device and with the stage of PAD ; however , this trend was not statistically significant ( P>.05 for all ) . CONCLUSION We report moderate complication rates  of collagen-based VCDs in patients with significant PAD . Our data suggest that Angio-Seal may be safe in patients with PAD after catheter intervention . Further r and omized trials with larger sample size comparing VCD with st and ard manual compression in patients with significant PAD are required Background Access for endovascular repair of abdominal aortic aneurysms ( EVAR ) is obtained through surgical cutdown or percutaneously . The only devices suitable for percutaneous closure of the 20 French arteriotomies of the common femoral artery ( CFA ) are the Prostar ™ and Proglide ™ devices ( Abbott Vascular ) . Positive effects of these devices seem to consist of a lower infection rate , and shorter operation time and hospital stay . This conclusion was published in previous reports comparing techniques in patients in two different groups ( cohort or r and omized ) . Access techniques were never compared in one and the same patient ; this research simplifies comparison because patient characteristics will be similar in both groups . Methods / Design Percutaneous access of the CFA is compared to surgical cutdown in a single patient ; in EVAR surgery , access is necessary in both groins in each patient . R and omization is performed on the introduction site of the larger main device of the endoprosthesis . The contralateral device of the endoprosthesis is smaller . When we use this type of r and omization , both groups will contain a similar number of main and contralateral devices . Preoperative nose cultures and perineal cultures are obtained , to compare colonization with postoperative wound cultures ( in case of a surgical site infection ) . Furthermore , patient comfort will be considered , using VAS-scores ( Visual analog scale ) . Punch biopsies of the groin will be harvested to retrospectively compare skin of patients who suffered a surgical site infection ( SSI ) to patients who did not have an SSI . Discussion The PiERO trial is a multicenter r and omized controlled clinical trial design ed to show the consequences of using percutaneous access in EVAR surgery and focuses on the occurrence of surgical site infections . Trial registration NTR4257 10 November 2013 , NL44578.042.13 PURPOSE This study was design ed to describe and evaluate our preliminary results with a percutaneous arterial closure device as compared to those obtained with conventional femoral surgical cut down during endovascular repair of abdominal aortic aneurysms ( AAA ) . MATERIAL AND METHODS Between January 2004 and December 2006 , 40 of 86 AAA patients selected for endovascular repair met the criteria for inclusion in this study . Nineteen of these patients ( Group A ) received a bifurcated endograft placed by direct puncture of the femoral arteries ( 38 femoral triangles ) with closure by a Prostar((R ) ) percutaneous arterial closure device ( Abbott ) . The other 21 patients ( control group B ) were managed with a bifurcated endograft placed by conventional open surgery ( 42 femoral triangles ) . Data concerning all 40 patients were collected prospect ively and analyzed . RESULTS The technical success rate was 92 % ( group A ) vs 90 % ( group B ) , P=0.79 . The incidence of perioperative complications was 16 % ( 3/19 ) in group A and 14 % ( 3/21 ) in group B ( P=0.89 ) . The mean hospital stay was 5.8 days in group A and 7.8 days in group B ( P=0.05 ) . The difference in the length of hospitalisation was associated with reduced cost for the percutaneous group ( 5579.60 euros vs. 7503.60 euros ; P=0.04 ) , that counterbalanced the cost induced by the Prostar XL((R ) ) suture mediated device . Mean follow-up in both groups was 12 months . The overall incidence of locoregional complications after one year of follow-up was 11 % ( 2/19 ) in group A and 19 % ( 4/21 ) in group B ( P=0.45 ) . CONCLUSION This study confirms the feasibility and safety of total percutaneous endovascular AAA repair . Our preliminary results suggest that the costs paid by healthcare providers for endovascular AAA repair might not be increased with the selective use of percutaneous closure devices This article addresses the utility of Angio-Seal versus manual hemostasis in anticoagulated patients following neurointerventional procedures . In a study of 174 punctures , 104 were closed with Angio-Seal and the rest with manual compression . All patients had activated clotting time values between 250–500 seconds at the time of closure . Mean hemostasis times were significantly longer with manual compression and hematomas 3 times more common . Using Angio-Seal led to arterial occlusion in 
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The review demonstrated that VCDs provided improvement in the patients ’ comfort and satisfaction as well as in the time to hemostasis and ambulation .
Conclusions VCDs have shown marked improvement in patients ’ comfort and satisfaction as well as in time to hemostasis and ambulation after percutaneous vascular procedures .
VCDs have a low incidence of major complications and high success rates , which provides convenience for the practitioner and facilitates turnover of patients .