SCAI Best Practices for Vascular Access and Closure

October 7, 2019

Raj Tayal: Axillary “Dry Closure”

Dr. Rajiv Tayal, one of the world’s experts on axillary access, talks to Dr. Cathy Jeon about the section he contributed to the SCAIVascular Access, Management, and Closure: Best PracticeseBook. Dr. Tayal describes the book as “non-branded, open for everyone, freely downloadable, and interactive. You can click on videos. You can click on links. You can keep it on your phone. It’s probably one of the coolest things I’ve worked on with so many different authors and so many different experts in so many different areas.”

In his section of the book, Dr. Tayal states that “dry closure” technique coupled with double Perclose or “hybrid closure” techniques can reduce the risks of bleeding and vascular complications and facilitate successful, rapid hemostasis. He provides a step-by-step procedure for “dry closure” and briefly discusses post closure complications. His section also contains 3 case studies:

  • Case 1: Axillary artery “dry closure” using ipsilateral radial artery
  • Case 2: Inadequate hemostasis managed with prolonged inflation
  • Case 3: Failed pre-close technique managed with covered stent

The free SCAI ebook, edited by Dr. Adhir Shroff and Dr. Duane Pinto, discusses routine (<8 Fr) arterial access and closure for coronary and structural heart procedures as well as best practices for large bore (>8 Fr) access and closure procedures. It also has sections on identification, prevention, and management of access and closure site complications.

In addition percutaneous axillary access best practices, the eBook includes topics such as ultrasound guidance for femoral access, manual compression and assisted manual compression for femoral closure, micropuncture technique for femoral access and coronary catheterizations and interventions, best practice algorithm for large bore femoral artery access, and closure devices and techniques.

The eBook, with more than 7500 downloads within the first few months of its release, is designed for fellows in training and early career physicians, as well as experienced operators for immediate clinical applications. This free “live” eBook is updated on a regular basis and is available from the links in this article as well as the SCAI website and

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