{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:42:04Z","timestamp":1761561724568},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,3,25]],"date-time":"2013-03-25T00:00:00Z","timestamp":1364169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the impact of suture\u2010mediated vascular closure devices (VCDs) on net adverse clinical events (NACEs) after balloon aortic valvuloplasty (BAV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Ischemic and bleeding complications are common following transfemoral BAV; however, previous studies have been single center and limited by varying definitions of major bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Effect of <jats:italic>Bivalirudin<\/jats:italic> on Aortic Valve Intervention Outcomes (BRAVOs) study was a retrospective observational study conducted at two high\u2010volume academic centers over a 6\u2010year period designed to compare the effect of bivalirudin versus unfractionated heparin. This is a subanalysis of 428 consecutive patients who underwent BAV (with 10\u201313 French sheaths) to compare the effect of hemostasis with VCDs versus manual compression utilizing standardized definitions. NACE was defined as the composite of major bleeding and major adverse clinical events (MACEs). All events were adjudicated by an independent clinical events committee who were blinded to antithrombin use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preclosure was performed in 269 (62.8%) of patients. While bivalirudin was used more frequently in those with pre\u2010closure (60.6% vs. 37.7%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), a history of prior BAV (11.1% vs. 3.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) and peripheral vascular disease (30.7% vs. 19.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) was more common in those not undergoing preclosure (<jats:italic>n<\/jats:italic>\u2009=\u2009159, 37%). Other clinical and demographic features were well balanced between groups. Vascular closure was associated with a significant reduction in NACE (24.5% vs. 10.0% <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Results remained significant after adjusting for baseline differences and bivalirudin use (OR 0.38, 95% CI: 0.21\u20130.68; <jats:italic>P<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study suggests that suture\u2010mediated vascular closure is associated with a substantial reduction in NACE after transfemoral BAV. Large randomized clinical trials should be conducted to confirm our results.\u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.24892","type":"journal-article","created":{"date-parts":[[2013,2,22]],"date-time":"2013-02-22T04:27:11Z","timestamp":1361507231000},"page":"148-153","source":"Crossref","is-referenced-by-count":11,"title":["The use of vascular closure devices and impact on major bleeding and net adverse clinical events (NACEs) in balloon aortic valvuloplasty: A sub\u2010analysis of the BRAVO study"],"prefix":"10.1002","volume":"83","author":[{"given":"Brian","family":"O'Neill","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Department of Medicine University of Miami Miller School of Medicine Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Singh","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine University of Miami Miller School of 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