Physicians at Arizona Heart Institute (AHI), a center purely dedicated to cardiovascular surgery and endovascular procedures (3,000 vascular and endovascular procedures per year), relies on the Boomerang system from Cardiva vascular closure for 70 to 80 percent of its cases.
They were drawn to the device’s principle advantage: No foreign material is left behind in either the vessel or subcutaneous tissue. It is also quick and easy to deploy and can be used in small vessels, even ones that are calcified, according to Venkatesh Ramaiah, M.D., director of peripheral vascular surgery and endovascular research at AHI. But the biggest benefit, he says, is the Boomerang allows blood flow to be maintained while the closure device is still in place.
The system is comprised of the Boomerang wire that is inserted into the femoral artery through the existing introducer sheath; a flat, low-profile disc that contours to seal the arteriotomy; and a clip placed on the skin to create site-specific compression of the arteriotomy and tract, establishing hemostasis. Once the fascial tract recoils back to its predilated state and the blood coagulates, the disc is collapsed, the wire is removed and finger pressure is applied.
Dr. Ramaiah finds the Boomerang suitable for almost all procedures, including in brachial arteries, for antegrade and retrograde punctures and in grafts. But because the system is a two-step procedure, with the second step — removing the device and applying manual compression for five minutes — being performed by recovery room nurses, there was initially some resistance to the device. ”Why not use manual compression only?” they questioned.
“With the Boomerang, the amount and time of manual pressure is markedly decreased — by about 80 percent — versus manual compression alone,” explained Dr. Ramaiah, which could be reason enough to convince some doubters. But more importantly, he says, AHI’s studies report a zero infection rate associated with the Boomerang.