Abstract
Annually, around 7 million percutaneous procedures are performed worldwide. However, the common femoral artery is still utilized for most of them, despite radial access becoming increasingly prevalent. This is an updated systematic review of studies discussing access site complications of manual compression versus closure devices after lower limb (LL) revascularization between 2017 and 2022. The PubMed and Google scholar databases were used to explore studies regarding our subject. The keywords included “access site, complications, manual compression, closure devices, LL, and revascularization” and were used in various combinations. The inclusion criteria were original studies that reported the access site complications of manual compression (MC) versus closure devices after LL revascularization and full-text- articles. Though 300 articles were obtained, only 7 of them met the inclusion criteria. The studies included 85,806 participants; 5 were prospective, 1 retrospective study, and 1 multicenter randomized clinical trial. The present systematic review indicated that vascular closure devices (VCDs) were independently related to forming fewer hematomas when MC and VCD were compared. Percutaneous endovascular operations’ feasibility, safety, and efficacy were excellent, with very little conversion and complication. Lesion therapy was technically successful in 98.2% and 100% of cases. When patients were undergoing endovascular revascularization of the LL s, FemoSeal® was recommended as the first-line hemostasis treatment. Technically, VCD interventions were successful for both FS and PG patients, and hemostasis was accomplished with complete success. EXOSEAL arm has a greater success rate. The combination treatment of two VCDs with routine ultrasonography guiding access showed excellent efficacy and safety results for individuals who underwent the endovascular treatments operation.

Key words: Access site, complications, manual compression, closure devices, lower limb, revascularization.