In a meta-analysis by Vaitcus, X was the only arterial closure device that resulted in a significant reduction in bleeding in patients undergoing PCI [4].
A separate meta-analysis by Nikolsky showed a strong trend for a reduction in major bleeding with X, compared with Z in PCI patients (odds ratio 0.46, P 5 0.062) [5].
The improved deployment success with the X in the current report and in a recent large registry, compared with earlier generation X suggests that this platform has the potential to further reduce major bleeding following PCI.
The shorter time to hemostasis and to ambulation with X compared with Y and with Z in this study is associated with greater patient satisfaction.
In addition to improving patient satisfaction, the earlier time to ambulation with X has the potential to reduce hospital costs, in part, due to shorter length of stay.
Additionally, if the high deployment success rate results in a low rate of major vascular complications, this would be expected to further reduce the cost.
Indeed, a recent single center registry suggests that the avoidance of vascular complications with X following PCI may be cost saving [8].
This study was not designed or powered to evaluate costs, which are very much driven by complications.
Nonetheless, if confirmed in a larger cohort, the avoidance of one major complication with X relative to Z or Y in the present series would be cost saving based on economic data from the group of Resnick and coworkers [8].