A single-device–first vascular closure technique was associated with fewer minor complications following transfemoral transcatheter aortic valve replacement (TAVR). The International Journal of Cardiology reports a study comparing a stepwise suture-based closure method with the conventional two-device pre-closure strategy.

The analysis included 446 matched patients drawn from an initial cohort of 671 treated between 2017 and 2023. Both groups had 223 patients each, with a median age of 81 ± 7 years and 53.6% women. Rates of the primary endpoint, defined as major vascular complications or Valve Academic Research Consortium (VARC 3) bleeding grade 2 or higher within 30 days, were similar between techniques (4% vs 5.8%, p = 0.38).

The single-device strategy demonstrated procedural advantages. Minor vascular complications were significantly lower (0.9% vs 4.9%, p = 0.011), and the total number of closure devices required per procedure was reduced (1.96 vs 2.09, p = 0.006). Additionally, 22% of patients in the single-device group did not require any extra devices after the initial deployment.

These results support the single-device escalation approach as an efficient and safe closure method that reduces minor vascular events without increasing major complications in contemporary TAVR practice.