Perclose Proglide® Multiple Device Deployment

Refer to Instructions for Use for additional information.

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Multiple Device Deployment

Pre-Close Technique
  • Pre-close technique means the Perclose ProGlide® suture is placed around the arteriotomy at the beginning of the procedure and knot advancement is placed on hold until the procedure is complete
  • The pre-close technique for sheath sizes greater than 8F, at least two devices and the pre-close technique are required
Pre-Deployment
  • Flush Marker Lumen
  • Insert the first of two devices over the guide wire
  • Remove guide wire when Guide Wire Exit Port is at skin level
  • Advance device until pulsatile flow is observed from Marker Lumen. In the vein, blood may only fill the Marker Lumen
  • Rotate the device 30° toward the patient's right side
Suture Deployment

1Lift Lever to deploy Foot. Do NOT deploy Foot before rotating device 30°

Retract device against anterior wall of vessel until marking has stopped

2Stabilize device. Depress the Plunger

3Remove Plunger using the thumb as a fulcrum. Pull suture taught. Cut suture with QuickCut or scissors

4Relax device and return Lever down to its original position

Suture Management
  • Retract device until Guide Wire Exit Port is at skin level
  • Remove the sutures and hold sutures tightly together
    • Blue limb = Rail
    • White limb = Non-Rail
  • Place a hemostat or clamp to hold the two sutures together at the distal end of the Non-Rail (white)
  • Pull on clamp until the suture is taut. Place clamped suture on patient's right side under sterile towel
  • Re-insert guide wire and remove device
Second Device Deployment
  • Repeat Pre-Deployment steps for each device
  • Second Device
    • Insert the device and rotate 30° toward the patient's left side and repeat deployment steps
    • Repeat suture management steps and place clamped suture on patient's left side under sterile towel
    • Knot advancement will be on hold until the end of procedure
  • Third device (optional as needed)
    • Third device should not be rotated. Device will deploy in a straight position
End of Procedure Suture Management
  • At the end of the procedure, advance a guide wire into the vessel
  • Remove clamp from first suture placed at patient's right side
  • Hold manual compression during sheath system removal and initial suture advancement
  • Wrap Rail (blue) around left forefinger and hold coaxial to tissue tract
  • Remove sheath and pull Rail (blue) simultaneously and slowly to advance suture knot
  • Re-clamp and return the suture to the right side of the patient to identify the first sutures deployed
  • Repeat steps above for suture set 2 and place on left side of patient. Repeat for suture set 3 if a third device was deployed
  • Do not lock or excessively tighten the knot while the guide wire is in the vessel
  • Use Snared Knot Pusher (SKP) to complete knot advancement and to lock the knot
  • The suture knots must be advanced in the order they were placed
  • Load Snared Knot Pusher (SKP) on to Rail (blue) suture of the first suture set placed on patient's right side
  • Advance Shared Knot Pusher (SKP) coaxial down to the vessel
  • Pull on the Non-Rail (white) suture to lock the knot
  • Repeat steps for sutures placed on patient's left side
  • Remove guide wire once bleeding is controlled
  • Load Snared Knot Pusher (SKP) on to Rail (blue) suture patient's right side and lock knot by pulling on the Non-Rail (white) suture
  • Repeat for sutures placed on the patient's left side
Assess Hemostasis
  • Assess hemostasis after all knots are advanced and locked
  • If adequate hemostasis is not observed, advance each knot again starting with the first suture deployed followed by the second suture deployed
  • Trim all sutures once adequate hemostasis is observed
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