A Comparison of Two Vascular Closure Strategies in Transcatheter Aortic Valve Replacement: Suture and Plug versus Suture Alone – A Systematic Review and Meta-Analysis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
INTRODUCTION: Vascular complications following transcatheter aortic valve replacement (TAVR) significantly contribute to morbidity and mortality. Conventional suture-based closure technique has been widely utilized for large-bore arterial access closure. Recent findings on hybrid strategy combining plug and suture-based devices has been on spotlight as it may improve the hemostatic efficacy and lower the access-site related complications and clinical outcomes. METHODS: We performed a systematic review and meta-analysis of studies comparing a suture-based approach with a hybrid closure strategy (suture+plug) in aortic stenosis patients undergoing TAVR. Included studies were appraised following the Cochrane Risk of Bias and Newcastle-Ottawa Scale tools. Forest plots were extracted in Review Manager with a main outcome of pooled-risk ratio (RR). The primary endpoint was the composite of access-site related vascular complications as defined by Valve Academic Research Consortium criteria whilst secondary end-points were in-hospital bleeding, closure device failure, mortality, and unplanned endovascular or surgical intervention. RESULTS: Six eligible studies encompassing 2,064 patients were analyzed. Compared with suture-based closure, hybrid closure exhibited a lower rate of vascular complications (pooled-RR 0.46; 95% confidence interval [CI], 0.38-0.57; p < 0.001), closure device failure (pooled-RR 0.35; 95% CI, 0.13-0.96; p = 0.04), in-hospital bleeding events (pooled-RR 0.38; 95% CI, 0.26-0.55; p < 0.001), and mortality (pooled-RR 0.51; 95% CI, 0.26-0.99; p = 0.049). Unplanned endovascular or surgical intervention was no different among two groups (pooled-RR 0.42; 95% CI, 0.17-1.06; p = 0.07). CONCLUSION: Hybrid vascular closure strategy offers better efficacy with fewer complications amongst patients undergoing TAVR, directing the clinical adoption of hybrid techniques, although further large-scale multicenter studies are warranted to confirm the benefit and optimize patient selection.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.020 | 0.020 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it