InSeal VCD Large Bore Vascular Closure Device Safety and Effectiveness Clinical Study

The increasing variety of arterial devices having a large crossing profile requiring the use of a large bore sheath is mandating focus on large bore closure. Such procedures include endovascular abdominal repair (EVAR), thoracic (TEVAR) aortic repairs and transcatheter aortic valve implantation (TAVI) typically involve sheaths and delivery catheters with 14-25Fr profiles.

Today, the typical closing technique (labeled in Europe) for such large sheath size is a one where sutures are deployed prior to the insertion of the large sheath with the sutures tied at the end of the procedure. This technique is cumbersome, hard to learn, complex to use and has relative high complications and failure rate.

The InSeal VCD device model 13-517, is easy to use, fast, affords immediate reliable hemostasis, and supports a wide range of sheath punctures size and artery's dia. 6-10 mm, while leaving a minimal amount material behind and will not limit re-access.

While each of these features may be found in one commercial device or another, to date there is no single device that meets all the market requirements.

Inclusion criteria

• Candidate for large bore catheterization procedure (such as TAVI, aortic endograft repair) using a CE approved 18Fr access sheath.
• Femoral, axillary or subclavian artery diameter at sheath insertion site is between 5.5-10mm
• Subject age is at least 18 years
• Patient has signed most recent approved version of the Informed Consent
• Existence of an additional arterial access port is required in instances where an occluding balloon is planned to be used as a safety precaution.

Exclusion criteria

• Women Of Child Bearing Potential (WOCBP)
• Legally non-competent patients
• Patient participating in another clinical study at the time of the InSeal VCD study
• Sheath insertion point is less than 12mm proximal to a bifurcation having a diameter greater than 2.5mm
• Side branch of greater than 2.5mm in diameter less than 4cm proximal to the puncture site.
• Known severe allergy to metal and membrane material
• Prior target artery closure with a vascular closure device having intravascular component (such as Angio-Seal) 30 days prior to catheterization
• Subjects with known coagulopathy, preexisting hematoma, arteriovenous fistula, or pseudoaneurysm at the vessel access site prior to artery closure
• Patients that do not tolerate aspirin and clopidogrel anticoagulation treatment
• Prior vascular surgery or vascular graft in region of access site
• Significant calcification, atherosclerotic disease, or stent within 1.5 cm of the puncture site that may interfere with the operation of the experimental device