A UNIVERSAL call for the optimisation of vascular closure devices

Clinical practice guidelines give a class I recommendation to the radial approach in preference to the femoral approach in patients undergoing coronary angiography (CA) and percutaneous coronary intervention (PCI)1. However, femoral access is still frequently utilised for large-bore access (i.e., complex PCI, percutaneous mechanical circulatory support, structural heart interventions) or in scenarios where a transradial approach is technically challenging or unfeasible. In the contemporary era of widespread radial adoption, a paradoxical increase in vascular complications with femoral artery catheterisation has been described, potentially attributable to declining operator experience with non-radial approaches2. Therefore, best practices need to be defined for ...