{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:08:27Z","timestamp":1788304107965,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Large\u2010bore femoral access is commonly required in transfemoral transcatheter aortic valve replacement (TF\u2010TAVR), but vascular access complications remain prevalent, impacting patient outcomes. Various vascular closure devices (VCDs) are used for hemostasis, including the suture\u2010based Prostar XL, Perclose ProGlide, and ProStyle, and the plug\u2010based MANTA device. However, comprehensive comparative evidence on these VCDs, particularly single Perclose strategies, is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and network meta\u2010analysis were conducted according to PRISMA guidelines. We included randomized and observational studies comparing the safety and efficacy of VCDs for large\u2010bore femoral access closure in TF\u2010TAVR patients. Primary outcomes included major vascular complications; secondary outcomes included major and minor bleeding, minor vascular complications, VCD failure, and all\u2010cause mortality. Frequentist and Bayesian analyses were performed using a random\u2010effects model, with additional subgroup analyses of single Perclose strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010five studies comprising 16,503 patients met inclusion criteria. The single Perclose strategy, with or without adjunct Angio\u2010Seal or FemoSeal, significantly reduced major vascular complications compared to dual Perclose (RR: 1.9, 95% CI [1.2\u22123.01]), MANTA (RR: 1.89, 95% CI [1.03\u22123.48]), and Prostar XL (RR: 3.46, 95% CI [1.94\u22126.18]). Among secondary outcomes, single Perclose also ranked highest in reducing minor complications and bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Single Perclose strategies, especially when combined with Angio\u2010Seal, demonstrated superior safety and efficacy for large\u2010bore femoral access closure following TF\u2010TAVR. These findings support the need for further randomized trials to validate single Perclose as a primary approach in TF\u2010TAVR vascular closure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31565","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T02:21:57Z","timestamp":1745806917000},"page":"423-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Vascular Closure Devices for Large Bore Femoral Access After Transfemoral Transcatheter Aortic Valve Replacement: A Network Meta\u2010Analysis"],"prefix":"10.1002","volume":"106","author":[{"given":"Sunil","family":"Upadhaya","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiology Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Upreti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bella","family":"Gonzalez\u2010Perez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiology Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radia","family":"Ksayer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiology Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Cox\u2010Alomar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Cardiology University of Miami Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Sanina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiology Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Irimpen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"Farhan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Lenox Hill Hospital Northwell Health New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Wiley","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiology Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29501"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231222314"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2022.08.011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27595"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.07.030"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12206697"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.08.041"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.057856"},{"key":"e_1_2_9_11_1","first-page":"1","article-title":"D.J. 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