Self-sealing, Large Bore Arterial Punctures: A Counterintuitive New Phenomenon

[+] Author and Article Information
Blayne A. Roeder, Farshid Sadeghi

School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907-1288

Charles F. Babbs

Department of Basic Medical Sciences, Purdue University, West Lafayette, IN 47907-1246

William E. Schoenlein

Department of Biomedical Engineering, Purdue University, West Lafayette, IN 47907-1296

Klod Kokini

School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907-1288Department of Biomedical Engineering, Purdue University, West Lafayette, IN 47907-1296

J Biomech Eng 124(4), 342-346 (Jul 30, 2002) (5 pages) doi:10.1115/1.1488935 History: Received October 01, 2000; Revised April 01, 2002; Online July 30, 2002
Copyright © 2002 by ASME
Your Session has timed out. Please sign back in to continue.


Mendel, D., 1968, A Practice of Cardiac Catheterization, Blackwell Scientific Publications, Oxford, UK.
Topol, E. J., 1994, “Quality of Care in Interventional Cardiology,” In: E. J. Topol (Ed), Textbook of Interventional Cardiology (Second Edition), WB Saunders, Philadelphia, pp. 1354–1356.
Bos,  J. J., Hunink,  M. G., and Mali,  W. P., 1996, “Use of a Collagen Hemostatic Closure Device to Achieve Hemostasis After Arterial Puncture: A Cost-Effectiveness Analysis,” J. Vasc. Interv Radiol., 7(4), pp. 479–486.
Popma,  J. J., Satler,  L. F., Pichard,  A. D., and Kent,  K. M., 1993, “Vascular Complications After Balloon and New Device Angioplasty,” Circulation, 88(4), pp. 1569–1578.
Nasser,  T. K., Mohler,  E. R., Wilemsky,  R. L., Hathaway,  D. R., Camppbell,  A., Chuan,  Y. C., Clark,  C., Merritt,  A. J., Bucher,  T. A., and Leon,  M. B., 1995, “Peripheral Vascular Complications Following Coronary Interventional Procedures,” Clin. Cardiol. 18(11), pp. 609–614.
Posey,  J. A., and Geddes,  L. A., 1973, “Measurement of the Modulus of Elasticity of the Arterial Wall,” Cardiovasc. Res. Cent. Bull., 11, pp. 83–103.
Fung, Y. C., 1993, Biomechanics: Mechanical Properties of Living Tissues, Springer-Verlag, New York, NY.
Humphrey,  J. D., 1995, “Mechanics of the Arterial Wall: Review and Directions,” Crit. Rev. Biomed. Eng., 23(10), pp. 1–162.
Hardman, J. G., and Limbird, L. E., Eds., 1996, Goodman & Gilman’s The Pharmacological Basis of Therapeutics, McGraw-Hill, New York, NY.
Semler,  H. J., 1985, “Transfemoral Catheterization: Mechanical Versus Manual Control of Bleeding,” Radiology, 154, pp. 234–235.
Nordrehaug,  J. E., Chronos,  N. A., Foran,  J., Wainright,  R., Rickards,  A. F., Buller,  N. P., and Sigwart,  U., 1992, “Randomized Evaluation of a New Inflatable Femoral Artery Compression Device After Cardiac Angiography,” Circulation, 86(4), pp. 382–382.
Krause,  P. B., and Klein,  L. W., 1993, “Utility of a Percutaneous Collagen Hemostasis Device: To Plug or Not To Plug?,” J. Am. Coll. Cardiol., 22(5), pp. 1280–1282.
Sanborn,  T. A., Gibbs,  H. H., Brinker,  J. A., Knopf,  W. D., Kosinski,  E. J., and Roubin,  G. S., 1993, “A Multicenter Randomized Trial Comparing a Percutaneous Collagen Hemostasis Device with Conventional Manual Compression After Diagnostic Angiography and Angioplasty,” J. Am. Coll. Cardiol., 22(5), pp. 1273–1279.
Webb,  J. G., Carere,  R. A., and Dodek,  A. A., 1993, “Collagen Plug Hemostatic Closure of Femoral Arterial Puncture Sites Following Implantation of Intracoronary Stents,” Cathet Cardiovasc. Diagn., 30(4), pp. 314–316.
Vonhoch,  F., Neumann,  F. J., Theiss,  W., Kastrati,  A., and Schomig,  A., 1995, “Efficacy and Safety of Collagen Implants for Hemostasis of the Vascular Access Site After Coronary Balloon Angioplasty and Coronary Stent Implantation—a Randomized Study,” Eur. Heart J., 16(5), pp. 640–646.
Silber,  S., 1998, “Hemostasis Success Rates and Local Complications with Collagen After Femoral Access for Cardiac Catheterization: Analysis of 6007 Published Patients,” Am. Heart J., 135(1), pp. 152–156.
Falstrom,  J. K., Goodman,  N. C., Ates,  G., Abbott,  R. D., Powers,  E. R., and Spotnitz,  W. D., 1997, “Reduction of Femoral Artery Bleeding Post Catheterization Using a Collagen Enhanced Fibrin Sealant,” Cathet Cardiovasc. Diagn., 41(1), pp. 79–84.
Kipshidze,  N., Ferguson,  J., Macris,  M. P., Clubb,  F., Cloy,  M., Horn,  J., Sperl,  F., Sahota,  H., Keelan,  M. H., and Nikolaychik,  W., 1998, “Percutaneous Application of Fibrin Sealant to Achieve Hemostasis Following Arterial Catheterization,” J. Invasive Cardiol., 10(3), pp. 133–141.
Kussmaul,  W. G., Buchbinder,  M., Whiltow,  P. L., Aker,  U. T., Heuserr,  R. R., King,  S. B., Kent,  K. M., Leon,  M. B., Kolasky,  D. M., and Sandza,  J. G., 1996, “Femoral Artery Hemostasis Using an Implantable Device (Angio-Seal(TM)) After Coronary Angioplasty,” Cathet Cardiovasc. Diagn., 37(4), pp. 362–365.
Seidelin,  P. H., and Adelman,  A. G., 1997, “Mobilization Within Thirty Minutes of Elective Diagnostic Coronary Angiography: a Feasibility Study Using a Hemostatic Femoral Puncture Closure Device,” J. Interv. Cardiol., 10(6), pp. 409–415.


Grahic Jump Location
Standard (bevel-up) needle orientation compared to modified (bevel-down) needle orientation
Grahic Jump Location
Leak rates for large bore carotid artery punctures in anesthetized pigs using standard (bevel-up) and modified (bevel-down) techniques with and without topical phenylephrine. Leak rates per 100 mmHg arterial pressure are shown after 1 min (○) and 3 min (▵) of compression following puncture. Black bars show median leak rates after 1 min of compression following puncture. White bars show median leak rates after 3 min of compression following puncture. For the modified technique with topical phenylephrine the median leak rate at 3 min was zero, i.e. the vessel self-sealed.
Grahic Jump Location
Standard and modified needle insertions create distinct cut geometries and can be described by a needle entry angle. The needle entry angle (θ ) is the angle between the inner wall of a vessel and the cut in the wall. For needle entry angles greater than 90 degrees (Standard), pressure on the flap opens the wound. When the angle is less than 90 degrees (Modified), pressure on the flap closes the wound.
Grahic Jump Location
A simple finite element model of a thick walled elastic tube with a “modified” puncture demonstrates self-sealing behavior. Displacement magnitude (mm) is plotted on the contour. The model was solved in ANSYS with a Young’s modulus of 1.60 MPa, Poisson’s Ratio of 0.45 and intraluminal pressure of 140 mmHg.



Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In