In Reply Dr Hoffer questions whether the advantage of a 9-minute reduction in time to hemostasis observed with vascular closure devices (VCDs) compared with manual compression in our trial was real. In his opinion, the reduction in time to hemostasis may not have been observed had the time needed for angiographic evaluation of the punctured artery been taken into account in the VCD group.
However, angiographic evaluation of the punctured artery is a common practice in many centers, irrespective of vascular closure strategy used. It takes less than 1 minute to perform and helps identification of access site problems that require special treatment before the patient leaves the catheterization laboratory.
Schulz-Schüpke S, Kastrati A, for the Instrumental Sealing of Arterial Puncture Site–CLOSURE Device vs Manual Compression (ISAR-CLOSURE) Trial Investigators. Assessing the Benefit of Vascular Closure Devices After Femoral Artery Puncture—Reply. JAMA. 2015;313(8):855-856. doi:10.1001/jama.2015.427