{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T05:37:14Z","timestamp":1741153034800,"version":"3.38.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2015,5,23]],"date-time":"2015-05-23T00:00:00Z","timestamp":1432339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> The AXERA 2 low-angle vascular access device utilizes a dual arteriotomy mechanism in which the standard access tract is compressed by a vascular sheath inserted over the second, low-angle tract. It is unknown whether this device could be effectively used with 21-gauge micropuncture access, as the micropuncture introducer makes a larger arteriotomy than the 19-gauge needle provided with the AXERA 2 system. <\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p> A retrospective review was performed on 189 patients who underwent common femoral artery access for diagnostic cerebrovascular angiography using either combined micropuncture and AXERA 2 access or standard access with manual pressure hemostasis. Demographic and procedural data were reviewed along with complications related to vascular access and times to bed elevation, ambulation and discharge. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Combined micropuncture and AXERA 2 access was performed on 110 patients and 79 patients had standard access. The AXERA device was successfully used in 91.8% of the cases. Demographic data, anticoagulant use and sheath sizes were similar between both subsets. Use of the AXERA 2 was associated with two bleeding complications (1.8%) compared with 10 (12.7%) with manual pressure hemostasis alone. Institution-specific protocol allowed shorter mean manual compression time, as well as shorter times to ambulation and discharge with the AXERA 2. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Use of the AXERA 2 device with micropuncture access did not infer increased bleeding risk than standard arterial access in this patient series. The considerable incidence of device use failures suggests a learning curve associated with its use. <\/jats:p><\/jats:sec>","DOI":"10.5301\/jva.5000388","type":"journal-article","created":{"date-parts":[[2015,6,5]],"date-time":"2015-06-05T10:18:40Z","timestamp":1433499520000},"page":"264-268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and efficacy of combined micropuncture and shallow angle femoral artery access for neurovascular angiography"],"prefix":"10.1177","volume":"18","author":[{"given":"Austin C.","family":"Bourgeois","sequence":"first","affiliation":[{"name":"University of Tennessee Graduate School of Medical Education, Knoxville, TN - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris T.","family":"Kolze","sequence":"additional","affiliation":[{"name":"University of Tennessee Graduate School of Medical Education, Knoxville, TN - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo S.","family":"Guimaraes","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of South Carolina, Charleston, SC - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander S.","family":"Pasciak","sequence":"additional","affiliation":[{"name":"University of Tennessee Graduate School of Medical Education, Knoxville, TN - USA"},{"name":"University of Tennessee Medical Center, Knoxville, TN - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S.","family":"Ferrell","sequence":"additional","affiliation":[{"name":"University of Tennessee Graduate School of Medical Education, Knoxville, TN - USA"},{"name":"University of Tennessee Medical Center, Knoxville, TN - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Bradley","sequence":"additional","affiliation":[{"name":"University of Tennessee Graduate School of Medical Education, Knoxville, TN - USA"},{"name":"University of Tennessee Medical Center, Knoxville, TN - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kvamme","sequence":"additional","affiliation":[{"name":"University of Tennessee Graduate School of Medical Education, Knoxville, TN - USA"},{"name":"University of Tennessee Medical Center, Knoxville, TN - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,5,23]]},"reference":[{"issue":"5","key":"bibr1-jva.5000388","doi-asserted-by":"crossref","first-page":"368","DOI":"10.3109\/00016925309136722","volume":"39","author":"Seldinger SI","year":"1953","journal-title":"Acta Radiol"},{"key":"bibr2-jva.5000388","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2011.49.3.153"},{"key":"bibr3-jva.5000388","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2013.01.012"},{"key":"bibr4-jva.5000388","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20922"},{"key":"bibr5-jva.5000388","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00101-9"},{"key":"bibr6-jva.5000388","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2012.10.005"},{"issue":"18","key":"bibr7-jva.5000388","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1161\/CIR.0b013e3181f9b345","volume":"122","author":"Patel MR","year":"2010","journal-title":"Circulation"},{"key":"bibr8-jva.5000388","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2433060536"},{"issue":"1","key":"bibr9-jva.5000388","first-page":"73","volume":"25","author":"Sheth RA","year":"2014","journal-title":"Quality improvement guidelines for vascular access and closure device use. 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