Figure 4.

Recommended practices for the perclose proglide vascular closure device. The Perclose Proglide platform (Abbott, Chicago, IL) is a suture-mediated vascular closure device commonly used in contemporary practice to hemostase standard and large bore femoral arterial access sites. It consists of two needles in the proximal compartment and a catheter that house the suture. It is 0.035″ J wire compatible. This cartoon depiction demonstrates the steps of large bore access and closure using this platform. (A) Using ultrasound guidance, the common femoral artery is accessed with a 21 gauge micrpuncture needle 1-3 cm below the probe. (B) Once femoral access is obtained, a.018″ micro access guidewire should then be advanced under fluoroscopy to ensure appropriate passage into the ipsilateral common iliac artery and abdominal aorta. (C) Following confirmation of the femoral access site, the arteriotomy may be “pre-closed” using 1 or 2 Proglide sutures, typically in the 10- and 12-o’clock positions. Here, the percutaneous ventricular assist device is secured in place following dilation of the arteriotomy (D) During deployment of the Proglide system, the catheter is advanced over an 0.035″ J wire through the arteriotomy. (E-F) Once the return of pulsatile blood is noted from the side arm, the device lever is pulled and two simultaneous needles are deployed through the anterior wall of the femoral artery utilizing the non-biodegradable polypropylene microfilament with preformed knot that is tightened to form the suture loop. The suture is then retracted to the anterior wall of the arteriotomy site and deployed to achieve hemostasis.