Choosing the safest method to close large-bore arterial access sites after cardiac procedures remains a crucial procedural decision. A patient-level meta-analysis published in EuroIntervention compared suture-based and plug-based vascular closure techniques used after transcatheter aortic valve implantation (TAVI).

The analysis combined data from two randomized controlled trials involving 722 patients. Vascular complications, the primary endpoint, occurred significantly less often with the suture-based technique (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.35–0.82). Access-site bleeding was also lower with suture-based repair (OR 0.41, 95% CI 0.18–0.94). Patients treated with the suture-based method were less likely to require endovascular stenting or vascular surgery (OR 0.22, 95% CI 0.06–0.79).

Outcomes with the plug-based approach were favorable only in larger-sized vessels. Overall, the findings suggest that suture-based closure offers a safer and more reliable option to reduce vascular and bleeding complications following large-bore arterial interventions.