Background Arterial puncture closure devices (APCD) are frequently used after cardiac catheterization. Here, the diagnosis and therapy of femoral artery complications after the use of the Angio-Seal APCD is reported.
Patients and methods The Angio-Seal APCD was deployed in 1600 patients undergoing transfemoral catheterization.
Results In 7 of 1600 cases (0.4%) vascular complications occurred following Angio-Seal deployment. Diagnosis was made by duplex sonography. Intraoperative findings consisted of a complete occlusion with dissection of the femoral artery in all patients. In 6 cases, the femoral bifurcation had to be reconstructed after endarterectomy. Follow-up is complete with a mean of 6 months.
Conclusion The Angio-Seal device should not be used for closure of the superficial femoral artery and in patients with severe arteriosclerosis. The application of arteriography as well as the use of ultrasound-guided puncture is advisable. In all cases, surgical intervention was successful and an adequate therapy for management of complications.
Kussmaul WG, Buchbinder M., Whitlow PL, et al. Rapid arterial hemostasis and decreased access site complications after cardiac catheterization and angioplasty. J Am Coll Cardiol . 1995;25:1685-1692.
2.
Duffin DC, Muhlestein JB, Allisson SB, et al. Femoral arterial puncture management after precutaneous coronary procedures: a comparison of clinical outcomes and patient satisfaction between manual compression and two different vascular closure devices. J Invasive Cardiol. 2001;13:354-362.
3.
Naser T., Mohleri EI, Wilensky R., Hathaway D.Peripheral vascular complications following coronary interventional procedures . Clin Cardiol. 1995;18:609-614.
4.
Omoigui N., Califf R., Pieper K., et al. Peripheral vascular complications in the coronary angioplasty versus excisional artherectomy trial (CAVEAT-I). J Am Coll Cardiol. 1995;26:922-930.
5.
Kirchhof C., Schickel S., Schmidt-Lucke C., Schmidt-Lucke JALocal vascular complications after use of the hemostatic puncture closure device Angio-Seal. VASA. 2002;31:101-106.
6.
Dregelid E., Jensen G., Daryapeyma A.Complications associated with the Angio-Seal arterial puncture closing device: intra-arterial deployment and occlusion by dissected plaque. J Vasc Surg. 2006;44:1357-1359.
7.
Biancari F., Ylonen K., Mosorin M., Lepojarvi M., Juvonen T.Lower limb ischemic complications after the use of arterial puncture closure devices. Eur J Vasc Endovasc Surg. 2006;32:504-505.
8.
Abando A., Hood D., Weaver F., Katz S.The use of the Angioseal device for femoral artery closure. J Vasc Surg. 2004;40:287-290.
9.
Eidt JF, Habibipour S., Saucedo JF, et al. Surgical complications from hemostatic puncture closure devices . Am J Surg. 1999;178:511-515.
10.
Koreny M., Riedmuller E., Nikfardjam M., Siostrzonek P., Mullner M.Arterial puncture closing devices compared with standard manual compression after cardiac catheterization. JAMA. 2004;291:350-357.
