Torque device suture technique to achieve hemostasis in large-bore venous access

Brian Karahalios, Stephanie F. Rojas, Rahul Singh, Miguel C. Cavazos, Ponraj Chinnadurai, C. Huie Lin

Research output: Contribution to journalArticlepeer-review


Objectives: To describe and compare a novel technique using a torque device to manage figure-of-eight suture tension for venous access hemostasis in patients who have undergone atrial septal defect (ASD) or patent foramen ovale (PFO) closure. Background: Large bore venous access has become increasingly important in transcatheter procedures, but management of hemostasis can be time-consuming and/or resource intensive. As such, various techniques have sought to provide cost effective and safe alternatives to manual compression. We describe a modification of the figure-of-eight suture technique wherein we apply a torque device to manage variable suture tension instead of tying a knot and compare it to the standard figure-of-eight suture technique. Methods: We performed a retrospective study of 40 consecutive patients who underwent ASD or PFO closure, 20 of whom underwent standard figure-of-eight technique and 20 of whom underwent figure-of-eight with torque device modification. Bleeding Academic Research Consortium definitions were used to categorize bleeding events. Results: The groups were similar in age, gender, weight, aspirin use, platelet count, procedure time, hemoglobin, and international normalized ratio. Standard figure-of-eight suture had seven patients with bleeding, with six classified as BARC II and one as BARC I. Figure-of-eight plus torque device had three patients with bleeding, with two classified BARC II and one as BARC I. There were no incidences of hematoma in either group. Conclusion: The torque device suture technique is a unique modification of the figure-of-eight suture technique to achieve venous hemostasis. In addition, the modification allows secure and variable suture tension as well as easy removal by nursing staff.

Original languageEnglish (US)
Pages (from-to)722-725
Number of pages4
JournalCatheterization and Cardiovascular Interventions
Issue number4
StatePublished - Mar 1 2020


  • closure
  • figure-of-eight
  • venous hemostasis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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