The application of a vascular closure device for closing a gastrostomy opening used for procedural access

• Published in: British journal of radiology 2019-07, Vol.92 (1099), p.20180837-20180837
• Main Authors: Cho, Sung Bum, Kim, Hyoung Rae, Jung, Eui-Chul, Chung, Hwan Hoon, Lee, Seung Hwa, Park, Beom Jin, Sung, Deuk Jae
• Format: Article
• Language: English
• Subjects: Animals; Equipment Design; Feasibility Studies; Gastrostomy - instrumentation; Gastrostomy - methods; In Vitro Techniques; Models, Animal; Stomach - surgery; Sutures; Swine; Vascular Closure Devices
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20180837

To study the feasibility of applying the Perclose ProGlide vascular closure device (PPVCD) for closing a gastrostomy opening for procedural access in the swine stomach in order to prevent peritoneal leakage. The study included four experimental groups: one manual suture ( = 10), two manual sutures ( = 10), one PPVCD suture ( = 10), and two PPVCD sutures ( = 5). In the two PPVCD sutures group, the "pre-close" technique was used. The leak pressure was measured, and statistical analysis was conducted to compare the leak pressures among the experimental groups. The gastrostomy openings were successfully closed in all experimental groups. The median (range) values of leak pressure (mmHg) for each experimental group were as follows: one manual suture, 86.0 (75.0-110.0); two manual sutures, 98.5 (44.0-130.0); one PPVCD suture, 96.5 (56.0-119.0); and two PPVCD sutures, 98.0 (66.0-104.0). The Mann-Whitney test revealed no statistically significant difference in leak pressure between the manual ( = 20) and PPVCD ( = 15) suture groups. The Kruskal-Wallis test revealed no statistically significant difference in leak pressure among the four experimental groups. The Bonferroni post hoc test also revealed no statistically significant difference in the pairwise comparisons among the groups. Application of PPVCD is feasible for the closure of gastrostomy openings in an animal model and is as effective as a manual suture. In our study, percutaneous closure of gastrostomy opening using PPVCD was possible; animal survival studies and development of specific devices are needed before clinical application.