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  • Safety and Efficacy of Percutaneous Femoral Artery Access Followed by Mynx Closure in Cerebral Neurovascular Procedures: a Single-Center Analysis

    Final Number:

    Robert Austin Miller BS MD; Ramesh Grandhi MD; Hilal Kanaan; Aalap C. Shah BS; Gillian Harrison MD; Tudor Jovin MD; Brian T. Jankowitz MD; Michael B. Horowitz MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Percutaneous transfemoral arterial procedures rely on a variety of vascular closure methods. We studied closure success and complications after using the Mynx vascular closure device in cerebral neurovascular procedures.

    Methods: We prospectively analyzed patients undergoing diagnostic cerebral angiogram or neurointervention with arteriotomy closure using the Mynx device. Patient demographics and procedural factors were recorded. Statistical analyses compared groups and identified predictors of device failure and complication.

    Results: A total of 766 patients, 59% female, mean age 55.5 years (SD 14.2), mean BMI of 29.1 kg/m2 (SD 7.4), underwent 937 neurovascular procedures in a 10-month period. Device success was achieved in 92% of patients; lower BMI, higher number of antithrombotic medications, larger sheath size, and performance of a neurointerventional procedure predicted Mynx failure. Complications occurred in 2.45% of procedures, with older age, lower BMI, higher number of antithrombotic medicines used, higher INR, lower platelet count, and Mynx device failure conferring an increased risk of complication.

    Conclusions: The Mynx device is safe and effective for cerebral neurovascular procedures; however, specific patient populations may warrant particular attention and thorough consideration of risks and benefits prior to employing the Mynx device for femoral arteriotomy closure.

    Patient Care: consideration given to various closure devices, recognition that not all devices are universal and should be patient specific given risk factors.

    Learning Objectives: 1. Education of femoral artery closure devices after invasive transfemoral procedures. 2. Education of risks associate with this procedure. 3. Identification of higher risk patients for potential device complication.

    References: n/a

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