Which statement best describes methods to obtain hemostasis after arterial access closure?

• A. Direct manual pressure
• B. Compression devices
• C. Vascular closure device
• D. Direct manual pressure, compression devices, and vascular closure device

Answer: (D)

Hemostasis after arterial access can be achieved by several approaches: direct manual pressure, compression devices, or vascular closure devices. Each method stops bleeding at the puncture site in the artery, and the choice depends on factors like sheath size, vessel anatomy, patient risk, and operator preference.

Direct manual pressure is the traditional method: the clinician applies firm, continuous pressure over the puncture site with sterile gauze until bleeding stops, which can take several minutes and requires careful monitoring for hematoma or rebleeding. Compression devices offer a mechanical alternative that provides consistent pressure over the puncture, often reducing time to hemostasis and improving patient comfort and workflow. Vascular closure devices seal the puncture site with sutures, anchors, or collagen plugs, potentially allowing earlier ambulation and quicker discharge in suitable patients, though they come with their own device-specific risks.

Because all three methods are valid options, the best answer encompasses direct manual pressure, compression devices, and vascular closure devices, reflecting the full spectrum of strategies used to achieve hemostasis after arterial access.