Abstract
Keywords
An 83-year-old man was admitted for transcatheter aortic valve implantation (ACURATE-Neo, Symetis SA) using transfemoral eco-guided approach (20 F). Incontrollable femoral bleeding occurred after incomplete arteriotomy closure with a Prostar XL device. Using a contralateral femoral access and a stiff guidewire, a covered 9 × 59 mm stent was deployed with persistent bleeding. A coaxial balloon was inflated, and the patient was urgently transferred to theater to undergo open surgical repair. After careful dissection, the tip of the guidewire was found in the subcutaneous tissue (Image 1) and also the covered stent and the inflated balloon, half way outside the arterial lumen (Image 2).
Stiff guidewire in the subcutaneous tissue outside arterial lumen.
Percutaneous stiches on the anterior wall of the common femoral artery and inflated balloon and guidewire outside the artery.
Probably, the contralateral guidewire came out of the lumen at the TAVI tear and insertion site. The “prophylactic” use of a contralateral guide prior to TAVI procedures is a useful measure described in the literature. However, for the success and safety of all endovascular procedures, exhaustive radiological monitoring of the exact intravascular location of the devices should be insistently taken before the deployment, to avoid severe arterial damage.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
