The use of vascular closure devices is reasonable for the purposes of achieving faster hemostasis and earlier ambulation compared with the use of manual compression.257,789 791 (Level of Evidence: B) Class III: NO BENEFIT 1. The routine use of vascular closure devices is not recommended for the purpose of decreasing vascu- lar complications, including bleeding.256,257,789 792 (Level of Evidence: B) See Online Data Supplement 30 for additional data regarding vascular closure devices. Vascular (arteriotomy) closure devices have been exten- sively reviewed,790 most recently in a 2010 AHA scientific statement,257 which issued several formal recommendations. The results of 4 meta-analyses have found that vascular closure devices decrease time to hemostasis compared with manual compression but do not decrease vascular complica- tions, bleeding complications, or the need for blood transfu- sions.256,789,791,793 Future studies of vascular closure devices need to be randomized, include high-risk patients and high-risk anatomy, use blinded endpoint adjudication as much as possible, use well-defined and comprehensive com- plication endpoints, and be adequately powered to detect clinically important endpoints, particularly bleeding and vas- cular complications. 6. Postprocedural Considerations Postprocedural considerations in patients undergoing PCI are discussed below and summarized in Table 14. Some recom- mendations and text regarding DAPT in Section 5.7.2 are intentionally repeated in this section for reader ease of use. 6.1. Postprocedural Antiplatelet Therapy: Recommendations Class I 1. After PCI, use of aspirin should be continued indef- initely.560 563 (Level of Evidence: A) 2. The duration of P2Y12 inhibitor therapy after stent implantation should generally be as follows: a. In patients receiving a stent (BMS or DES) dur- ing PCI for ACS, P2Y12 inhibitor therapy should be given for at least 12 months. Options include (Level of Evidence: B) b. 