scholarly journals Treatment of Infected Pseudoaneurysm of Femoral Artery after Vascular Closure Device Deployment: A Practical Solution

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Predrag Matic ◽  
Srdjan Babic ◽  
Slobodan Tanaskovic ◽  
Dario Jocic ◽  
Djordje Radak
Keyword(s):  
Femoral Artery ◽  
Arterial Occlusion ◽  
Surgical Excision ◽  
Common Femoral Artery ◽  
Coronary Intervention ◽  
Closure Device ◽  
Arteriovenous Fistulas ◽  
Percutaneous Coronary ◽  
Infected Pseudoaneurysm ◽  
Device Deployment

Like other invasive procedures, percutaneous coronary interventions are associated with complications. Most common access site for these procedures is common femoral artery. Complications such as groin and retroperitoneal hematoma can be encountered as well as pseudoaneurysms, arteriovenous fistulas, acute arterial occlusion, and infection. When infected pseudoaneurysm occurs, surgical treatment can be extremely difficult. We present a case of the patient in whom infected pseudoaneurysm of common femoral artery developed after percutaneous coronary intervention and was successfully treated by surgical excision and autoarterial graft insertion.

scholarly journals Stenosis Caused by Suture-Mediated Vascular Closure Device in an Angiographic Normal Common Femoral Artery: Its Mechanism and Management

2018 ◽  
Vol 53 (1) ◽  
pp. 58-61
Author(s):  
Young Jin Youn ◽  
Salman Khalid ◽  
Michael Azrin ◽  
Juyong Lee
Keyword(s):  
Femoral Artery ◽  
Vascular Complications ◽  
Bed Rest ◽  
Common Femoral Artery ◽  
Artery Stenosis ◽  
Closure Device ◽  
Standard Management ◽  
Percutaneous Coronary ◽  
Coronary Procedure ◽  
Femoral Puncture

Vascular closing devices (VCDs) are widely used to replace manual compression at the femoral puncture site and to reduce the discomfort of patients undergoing percutaneous coronary procedure by shortening bed rest. Among the vascular complications related to these devices, the femoral artery stenosis or occlusion is rarely reported, and its standard management is not well established. We report a case of symptomatic femoral artery stenosis caused by suture-mediated VCD and managed using rotational atherectomy device and balloon angioplasty. In addition, we propose the possible mechanisms for this complication.

scholarly journals Safety and Efficacy of a Novel “Hybrid Closure” Technique in Large-Bore Arteriotomies

2017 ◽  
Vol 26 (02) ◽  
pp. 116-120 ◽  
Author(s):  
Michael Amponsah ◽  
Rajiv Tayal ◽  
Zain Khakwani ◽  
Michael Sinclair ◽  
Najam Wasty
Keyword(s):  
Common Femoral Artery ◽  
Coronary Intervention ◽  
Arterial Calcification ◽  
Closure Device ◽  
Manual Compression ◽  
Closure Technique ◽  
Safe Alternative ◽  
Combined Use ◽  
Percutaneous Coronary ◽  
Balloon Technique

AbstractThe “preclose” technique employing two Perclose (P) devices is well established for large-bore artery (LBA) hemostasis. Occasionally, only one Perclose deploys successfully during the initial preclose because of arterial calcification necessitating the use of the crossover balloon technique to achieve hemostasis at the LBA. We sought to determine if the combined use of one Perclose and either one Angioseal or one Mynx vascular closure device (VCD) is a safe alternative closure technique large-bore arteriotomy closure.In total, 40 patients underwent high-risk percutaneous coronary intervention (HRPCI) with Impella support, of whom 38 had common femoral artery (CFA) arteriotomies and 2 underwent percutaneous axillary arteriotomy (AA). Prior to Impella insertion, one Perclose device was predeployed. At the end of HRPCI, Impella was removed and a 0.035″ wire was inserted through the Impella sheath. This sheath was then withdrawn over the wire, and partially deployed Perclose was fully deployed. A 6-Fr sheath was advanced over a 0.035″ wire into the CFA or AA, achieving hemostasis and reducing the LBA to a 6-Fr size. The 6-Fr arteriotomy was closed with a 6-Fr Mynx or Angioseal VCD. Patients were followed at day 1 and day 30.Hybrid closure was successful in 38 of 40 cases. In one case of Mynx balloon rupture, hemostasis was achieved with heparin reversal and manual compression. In the case of Perclose failure, crossover balloon tamponade at arteriotomy site and external manual compression achieved hemostasis. Patients were free of complications at day 1 and day 30.Hybrid closure with one Perclose and either one Mynx or one Angioseal VCD is safe and effective for LBA closure.

Closure device use for common femoral artery antegrade access is higher risk than retrograde access

2021 ◽  
Author(s):  
Joel L. Ramirez ◽  
Eric J.T. Smith ◽  
Devin S. Zarkowsky ◽  
Jose Lopez ◽  
Caitlin W. Hicks ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Common Femoral Artery ◽  
Closure Device ◽  
Device Use

Haematoma after Coronary Angiography and Percutaneous Coronary Intervention via the Femoral Artery Frequency and Risk Factors

2005 ◽  
Vol 4 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Kirsten Andersen ◽  
Marianne Bregendahl ◽  
Helen Kaestel ◽  
Mette Skriver ◽  
Jan Ravkilde
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Femoral Artery ◽  
Multivariate Logistic Regression Analysis ◽  
Coronary Intervention ◽  
Low Molecular Weight ◽  
Multivariate Logistic Regression ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Made In

Background: The most common complication after coronary angiography (CA) and percutaneous coronary intervention (PCI) is the development of haematoma. Several changes in procedures regarding CA and PCI have been made in our department in recent years. The aim of this audit is to establish how many patients develop haematoma after CA/PCI via the femoral artery and subsequently to find predictors that increase the risk of developing haematoma. Methods: We initially included 474 consecutive patients-322 patients undergoing CA and 141 patients undergoing PCI. Eleven patients were later excluded due to the absence of complete data. Thirty-three variables were registered in order to find predictors, which might increase the haematoma frequency. A univariate as well as a multivariate logistic regression analysis was performed. Results: Of the 463 patients, 6 patients developed a haematoma > 10 cm (1.3%) and 41 patients developed a haematoma > 5 cm (8.9%). The following factors were found to be associated with the generation of haematoma: Women, systolic blood pressure > 160 mm Hg, artery puncture > 1, sheath time > 16 min, ACT ≥ 175 s, Glycoprotein (GP) IIB/IIIa inhibitors, Low Molecular Weight Heparin before procedure, personnel change during compression, and anti-coagulant-treatment before procedure. Conclusions: The frequency of haematoma was 1.3% (> 10 cm) and 8.9% (> 5 cm), which corresponds with reports from similar studies and departments. The factors found to increase the risk of haematoma development can provide background for procedural changes and increase the focus on patients at increased risk in order to minimize the development of haematomas.

scholarly journals The efficacy of the figure-of-eight suture technique in the treatment of tunnel bleeding of the femoral artery route after percutaneous coronary intervention or angiography

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094730
Author(s):  
Ya Huang ◽  
Jing-Guo Nong ◽  
Qiao Xue ◽  
Quan-Zhou Feng ◽  
Cai-Yi Lu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Femoral Artery ◽  
Treatment Time ◽  
Coronary Intervention ◽  
Suture Technique ◽  
Manual Compression ◽  
Performance Time ◽  
Total Treatment Time ◽  
Percutaneous Coronary ◽  
Total Treatment

Objective To evaluate the efficacy of the figure-of-eight (FOE) suture technique in the treatment of tunnel bleeding after femoral artery puncture compared with manual compression (MC). Methods This prospective, randomized, controlled study enrolled patients that had received transfemoral coronary artery angiography or percutaneous coronary intervention and then developed tunnel bleeding. They were randomly assigned into two groups: FOE suture group (ES group) and manual compression group (MC group). Total treatment time, performance frequency, performance time, rate of deep vein thrombosis (DVT) and in-hospital time after the procedure were compared. Results A total of 152 patients were enrolled in the study (ES group, n = 63; MC group, n = 89). Compared with the MC group, the total treatment time (mean ± SD: ES 22.3 ± 5.4 h versus MC 26.8 ± 6.8 h), performance frequency (mean ± SD: ES 2.1 ± 0.7 versus MC 2.6 ± 1.1), performance time (mean ± SD: ES 8.9 ± 2.5 min versus MC 12.3 ± 4.1 min), in-hospital time after the procedure (mean ± SD: ES 3.5 ± 1.2 days versus MC 4.8 ± 2.1 days) and DVT rate (ES 0.0% versus MC 6.7%) were significantly lower in the ES group. Conclusion The FOE suture technique effectively treated tunnel bleeding after femoral artery puncture.

Surgical treatment of arterial ischemia associated with the use of the angioseal vascular closure device

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 334-337 ◽  
Author(s):  
Pontón ◽  
Negueruela ◽  
Bernal ◽  
García ◽  
Arnáiz ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Surgical Techniques ◽  
Common Femoral Artery ◽  
Point Of View ◽  
Heart Catheterization ◽  
Closure Device ◽  
Arterial Lesions ◽  
Arterial Repair ◽  
Atheroma Plaque

Background: Despite the theoretical effectiveness of the Angio-Seal closure device to control bleeding after arterial puncture it can increase the risk of ischemia. Objectives: To describe arterial lesions caused by the device, surgical techniques needed to repair those lesions and surgical outcome in patients who underwent surgery for arterial ischemia after heart catheterization. Patients and methods: Seven patients underwent surgery over a period of 12 months at our institution. Five patients underwent emergency surgery and two a delayed procedure. The cause of ischemia was dissection of an atheroma plaque at the puncture site in four cases, dissection of the superficial femoral artery in one case, thrombosis of the common femoral artery in one case, and plication of the posterior arterial wall in one case. Arterial repair in these patients required the insertion of a vascular graft in three cases, endarterectomy plus angioplasty in two cases, endarterectomy plus graft interposition plus thrombectomy of the superficial femoral artery in one case and endarterectomy plus femoropopliteal bypass in one case. Results: Treatment was successful in all patients. Mean follow up was 7.6 months (range 5-11 months). During the study period one patient died due to cardiopathy. No patients had to be re-operated and no limb losses were recorded. All the patients were asymptomatic from a vascular point of view with normal active lives for their age. Conclusions: Surgical repair is effective, although, generally, it is not restricted to a simple thrombectomy, requiring the use of different arterial repair techniques

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