The above letter was referred to Drs. Krajcer and Howell, who reply in this manner:
We appreciate Dr. Semler's comments regarding the costs and benefits of percutaneous hemostatic puncture closure devices in comparison with those of manual and mechanical compression. We agree with Dr. Semler that there is no evidence in the literature of a significant financial or other benefit achieved by using these devices in patients undergoing routine diagnostic procedures. The use of percutaneous hemostatic puncture closure devices is operator dependent, and proficiency is gained only by frequent use.
Our comment regarding the benefit of these devices 3 refers primarily to percutaneous repair of large-bore arterial access sites. For example, it is our opinion that percutaneous femoral closure devices such as Perclose are of great benefit in patients who require endoluminal repair of abdominal aortic aneurysms. 1,2 We agree that the use of these devices for routine peripheral and coronary intervention is of debatable importance.
References
- 1.Howell M, Villareal R, Krajcer Z. Percutaneous access and closure of femoral artery access sites associated with endoluminal repair of abdominal aortic aneurysms. J Endovasc Ther 2001;8:68–74. [DOI] [PubMed]
- 2.Haas PC, Krajcer Z, Diethrich EB. Closure of large percutaneous access sites using the Prostar XL Percutaneous Vascular Surgery device. J Endovasc Surg 1999;6:168–70. [DOI] [PubMed]
- 3.Krajcer Z, Howell MH. Update on endovascular treatment of peripheral vascular disease: new tools, techniques, and indications. Tex Heart Inst J 2000;27:369–85. [PMC free article] [PubMed]