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1 Supplementary Information Network Meta-analysis of Randomized Trials on the Safety of Vascular Closure Devices for Femoral Arterial Puncture Site Haemostasis Jun Jiang MD, PhD, Junjie Zou MD, PhD, Hao Ma MD, PhD, Yuanyong Jiao MD, Hongyu Yang MD, Xiwei Zhang MD, Yi Miao MD, PhD 1
2 Supplementary Figure S1 Risk of bias graph: the authors conclusions about the risk of each bias item are presented as percentages across all the included studies. 2
3 Supplementary Figure S2 Funnel plot of all included trials for detection of publication bias (t = 0.35; P = 0.725). 3
4 Supplementary Figure S3 Subgroup analysis of included studies excluding two studies conducted in the East Asian population stratified by the year of publication accessing the risk of combined adverse vascular events of VCDs versus MC. VCD = vascular closure device, MC = manual compression, M-H = Mantel-Haenzel, CI = confidence interval. 4
5 Supplementary Figure S4 Subgroup analysis of included studies excluding two non-english language studies stratified by the year of publication accessing the risk of combined adverse vascular events of VCDs versus MC. VCD = vascular closure device, MC = manual compression, M-H = Mantel-Haenzel, CI = confidence interval. 5
6 Supplementary Figure S5 Risk of haematomas associated with all VCDs versus MC of the included studies excluding two studies conducted in the East Asian population. VCD = vascular closure device, MC = manual compression, M-H = Mantel-Haenzel, CI = confidence interval. 6
7 Supplementary Figure S6 Risk of haematomas associated with all VCDs versus MC of included studies excluding two non-english language studies. VCD = vascular closure device, MC = manual compression, M-H = Mantel-Haenzel, CI = confidence interval. 7
8 Supplementary Table S1. Characteristics of the included studies Studies Year of VCD, No. publication of patients Schräder Sanborn Camenzind von Hoch Slaughter Kussmaul Beyer-Enke Seidelin Gwechenberger Ward Silber Gerckens 1999 (Techstar or Prostar), 298 Wetter 2000 (Techstar), 50 Noguchi 2000 (Prostar Plus), 30 Baim 2000 (Prostar Plus), 251 Díaz De La Llera Control, Followup (d) score Jadad No. of Country Funding patients MC, 50 Germany NR 42 3 MC, 209 USA Datascope Corp MC, 62 Switzerland NR 1 3 MC, 155 German NR 7 2 MC, 50 Canada NR 35 3 MC, 217 USA NR 60 3 MC, 48 Germany NR 84 2 Sherwood MC, 26 Canada Davis & 7 3 Geck MC, 29 Austria NR 7 2 Sherwood MC, 102 USA Davis & 30 2 Geck MC, 76 Germany NR 1 2 MC, 292 Germany NR 15 3 Philips MC, 50 Switzerland Medical Systems, In hospital 3 Inc. MC, 30 Japan NR 1 2 MC, 264 USA NR 30 2 MC, 75 Sevilla NR
9 The STST 2002 Duett, 392 MC, 238 USA NR 30 3 VasoSea Datascope Shammas 2002 USA l, 73 Corp. Rickli 2002 (Te chstar XL), 96 MC, 97 Switzerland NR 90 2 Angioseal, Michalis ; Duett, 281 Greece NR In hospital Yadav 2003 QuickSeal, SUB-Q MC, 158 USA 240 Inc Tron 2003, 91 MC, 76 France NR In hospital 2 Starnes 2003 (Techstar, Prostar XL), 52 MC, 50 USA NR Chevalier 2003 Daig MC, 306 France 306 Division 7 3 Castañeda 2003 QuickSeal, 85 MC, 56 USA NR 30 3 Reddy MC, 25 USA NR 7 2 Legrand ; Bio-DISC, 103 MC, 102 Belgium NR 1 3 Hermiller 2006 StarClose, Abbott MC, 91 USA 184 Vascular In hospital 2 Ansel 2006 EVS,243 MC, 119 USA Angiolink Co Upponi 2007 Angioseal, 50 MC, 50 UK NR Rastan ; D-Stat StarClose, Dry, 281 Switzerland NR Martin ;, 63 MC, 67 USA NR In hospital 2 Jensen FemoSto 2;, p, Sweden NR
10 Deuling ; StarClose, 150 MC, 150 Netherlands NR 1 2 Wong 2009 ExoSeal, Cordis MC, 134 USA 267 Corp StarClose,2 86; Sun 2009 (PROGLID E),183; Boomerang, 178 MC, 271 China NR In hospital 2 partly Hermanides 2010 from St. MC, 314 Netherlands 313 Jude Medical In hospital 3 Machnik MC, 110 Poland NR In hospital 2 Schulz-Schüpke 2014 FemoSeal, Deutsches 1509; MC, Germany Herzzentr ExoSeal, 1509 um Holm 2014 FemoSeal, 501 MC, 500 Denmark NR In hospital 3 NR = not reported, VCD = vascular closure device, MC, manual compression. 10
11 Supplementary Table S2. Node-splitting analysis of direct and indirect comparison of different vascular closure devices and manual compression Name Direct Effect Indirect Effect Overall P-Value AngioSeal, Duett (-1.48, 1.10) (-0.28, 2.96) (-0.59, 1.31) 0.14 AngioSeal, MC (-0.03, 0.82) (-0.34, 1.12) (0.02, 0.78) 0.99 AngioSeal, (-1.19, 1.55) (-0.17, 1.14) (-0.15, 1.04) 0.70 AngioSeal, StarClose (-0.48, 1.49) (-1.38, 0.55) (-0.56, 0.81) 0.18 AngioSeal, VasoSeal (-0.65, 1.33) (-0.30, 1.16) (-0.13, 1.01) 0.85 Duett, MC (-2.46, 0.73) (-0.60, 1.76) (-0.89, 0.98) 0.15 Duett, VasoSeal (-0.87, 1.75) (-1.22, 1.12) (-0.89, 1.05) 0.60 ExoSeal, FemoSeal (-1.53, 0.95) (-2.13, 0.93) (-1.44, 0.48) 0.76 ExoSeal, MC (-1.36, 0.53) (-1.20, 1.57) (-1.07, 0.55) 0.50 ExoSeal, (-1.78, 2.95) (-1.37, 0.62) (-1.12, 0.69) 0.50 MC, (-0.49, 0.55) (-1.69, 1.48) (-0.45, 0.53) 0.89 MC, StarClose (-1.20, 0.29) (-0.94, 2.18) (-0.95, 0.37) 0.25 MC, VasoSeal (-0.56, 0.64) (-0.95, 1.12) (-0.46, 0.54) 0.97, StarClose (-2.64, 0.47) (-0.92, 0.83) (-1.12, 0.46) 0.26 MC, manual compression. 11
12 Supplementary Table S3. Network meta-analysis (consistency model) of the risk ratio and 95% confidence intervals of haematomas associated with different vascular closure devices and manual compression of included studies excluding two studies conducted in the East Asian population AngioSeal 1.62 (0.68, 4.56) 1.20 (0.54, 2.82) 1.67 (1.13, 2.50) 1.47 (0.75, 3.15) 2.44 (0.84, 6.76) 1.45 (0.64, 3.11) 1.68 (0.91, 3.04) 0.62 (0.22, 1.46) ExoSeal 0.74 (0.28, 1.75) 1.03 (0.40, 2.23) 0.90 (0.30, 2.50) 1.51 (0.36, 5.00) 0.89 (0.25, 2.60) 1.03 (0.35, 2.56) 0.84 (0.36, 1.87) 1.36 (0.57, 3.61) FemoSeal 1.41 (0.66, 2.81) 1.22 (0.49, 3.21) 2.07 (0.57, 6.46) 1.22 (0.39, 3.43) 1.40 (0.55, 3.23) 0.60 (0.40, 0.88) 0.97 (0.45, 2.51) 0.71 (0.36, 1.52) MC 0.88 (0.49, 1.73) 1.46 (0.55, 3.76) 0.86 (0.39, 1.85) 1.00 (0.59, 1.66) 0.68 (0.32, 1.34) 1.12 (0.40, 3.29) 0.82 (0.31, 2.06) 1.14 (0.58, 2.05) 1.65 (0.49, 4.94) 0.98 (0.34, 2.56) 1.14 (0.48, 2.43) 0.41 (0.15, 1.19) 0.66 (0.20, 2.81) 0.48 (0.15, 1.76) 0.69 (0.27, 1.83) 0.61 (0.20, 2.05) QuickSeal 0.59 (0.18, 2.07) 0.69 (0.23, 2.08) 0.69 (0.32, 1.55) 1.13 (0.38, 4.06) 0.82 (0.29, 2.53) 1.16 (0.54, 2.56) 1.02 (0.39, 2.91) 1.69 (0.48, 5.67) StarClose 1.14 (0.48, 2.92) 0.60 (0.33, 1.10) 0.97 (0.39, 2.88) 0.71 (0.31, 1.82) 1.00 (0.60, 1.68) 0.88 (0.41, 2.10) 1.45 (0.48, 4.27) 0.88 (0.34, 2.10) VasoSeal MC, manual compression. 12
13 Supplementary Table S4. Network meta-analysis (consistency model) of the risk ratio and 95% confidence intervals of haematomas associated with different vascular closure devices and manual compression of included studies excluding two non-english language studies AngioSeal 1.68 (0.71, 4.80) 1.24 (0.56, 2.93) 1.73 (1.16, 2.56) 1.31 (0.68, 2.60) 2.48 (0.87, 6.63) 1.44 (0.67, 3.26) 1.71 (0.95, 3.19) 0.60 (0.21, 1.40) ExoSeal 0.74 (0.27, 1.70) 1.03 (0.39, 2.20) 0.78 (0.25, 2.02) 1.46 (0.36, 4.86) 0.86 (0.25, 2.56) 1.02 (0.35, 2.53) 0.81 (0.34, 1.78) 1.36 (0.59, 3.69) FemoSeal 1.40 (0.64, 2.77) 1.06 (0.41, 2.67) 2.02 (0.57, 6.21) 1.16 (0.40, 3.37) 1.39 (0.55, 3.27) 0.58 (0.39, 0.87) 0.97 (0.45, 2.56) 0.71 (0.36, 1.56) MC 0.75 (0.43, 1.38) 1.45 (0.55, 3.56) 0.84 (0.39, 1.88) 0.99 (0.60, 1.66) 0.77 (0.38, 1.48) 1.29 (0.49, 4.00) 0.95 (0.37, 2.45) 1.33 (0.73, 2.33) 1.91 (0.59, 5.47) 1.11 (0.41, 2.96) 1.31 (0.60, 2.80) 0.40 (0.15, 1.15) 0.68 (0.21, 2.75) 0.49 (0.16, 1.75) 0.69 (0.28, 1.83) 0.52 (0.18, 1.68) QuickSeal 0.58 (0.18, 2.06) 0.69 (0.24, 2.09) 0.69 (0.31, 1.49) 1.17 (0.39, 4.02) 0.86 (0.30, 2.49) 1.19 (0.53, 2.55) 0.90 (0.34, 2.45) 1.71 (0.49, 5.66) StarClose 1.18 (0.46, 2.96) 0.58 (0.31, 1.06) 0.98 (0.40, 2.90) 0.72 (0.31, 1.81) 1.01 (0.60, 1.67) 0.76 (0.36, 1.67) 1.45 (0.48, 4.11) 0.85 (0.34, 2.17) VasoSeal MC, manual compression. 13
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