scholarly journals Percutaneous closure of an iatrogenic right ventricular perforation with an angio-seal vascular closure device: a case report

2020 ◽  
Vol 4 (5) ◽  
pp. 1-4
Author(s):  
J J Coughlan ◽  
Richard Szirt ◽  
Ian Pearson ◽  
John Cosgrave
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Treatment Strategies ◽  
Coronary Intervention ◽  
Percutaneous Closure ◽  
Closure Device ◽  
Vascular Closure Device ◽  
Invasive Treatment ◽  
Iatrogenic Perforation ◽  
Post Procedure

Abstract Background Iatrogenic perforation of the right ventricle (RV) is a rare but recognized complication of pericardiocentesis. Treatment strategies for RV perforation include surgical repair and percutaneous closure. In this case report, we describe the use of an angio-seal vascular closure device (Terumo Interventional Systems) to seal an iatrogenic RV perforation secondary to incorrect placement of a pericardial drain. Case summary A 55-year-old female presented with an anterior ST-elevation myocardial infarction. Coronary angiography demonstrated occlusion of the left anterior descending artery. The patient went on to have primary percutaneous coronary intervention and both the left anterior descending and D1 were wired. During kissing balloon inflation, the Sion Blue wire migrated distally in the D1 causing an Ellis type 3 wire tip perforation in the distal D1. Emergency pericardiocentesis was performed however the 8 French (8 Fr) pericardial drain was inadvertently inserted into the RV. It was decided to attempt percutaneous closure with an 8 Fr angio-seal in the catheter lab under echocardiographic and fluoroscopic guidance. Our patient did not demonstrate any recurrence of pericardial effusion on repeat echocardiography over 60 days post-procedure. Discussion Our patient did not demonstrate any recurrence of pericardial effusion on repeat echocardiography over 60 days post-procedure. We feel that the angio-seal vascular closure device represents an effective, minimally invasive treatment for this rare but potentially catastrophic complication of pericardiocentesis. In this case, the technique spared our patient a sternotomy with its associated morbidity.

Femoral Vascular Closure Device: The Surgical View

Vascular ◽  
2008 ◽  
Vol 16 (5) ◽  
pp. 295-296
Author(s):  
Alfried Germing ◽  
Michael Lindstaedt ◽  
Delawer Reber
Keyword(s):  
Case Report ◽  
Coronary Angiography ◽  
Vascular Access ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Percutaneous Closure ◽  
Closure Device ◽  
Vascular Closure Device ◽  
The Common ◽  
Diagnostic Coronary Angiography

This case report describes the surgical findings of a percutaneous closure device, which was used after diagnostic coronary angiography. The features of the device are described. Surgeons should be familiar with the existence of these devices to avoid complications during vascular access procedures at the level of the common femoral artery.

scholarly journals Left atrial appendage perforation during appendage angiography treated by percutaneous left atrial appendage closure: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Catherine Champagne ◽  
Nicolas Dognin ◽  
Josep Rodés-Cabau ◽  
Jean Champagne
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Closure Device ◽  
Left Atrial Appendage Closure ◽  
Case Summary ◽  
Device Deployment ◽  
Laa Closure

Abstract Background Pericardial effusion is a common complication of percutaneous left atrial appendage (LAA) closure. Acute management is the cornerstone of pericardial effusion treatment and interrupting the intervention is often required. Case summary A 65-year-old man presented an acute 10 mm pericardial effusion following pigtail contrast appendage injection. A rapid Watchman Flex 24 mm (Boston Scientific) deployment permitted bleeding interruption. A needle pericardiocentesis was achieved in order to prevent any haemodynamical instability. Discussion This case report describes an atypical cause of pericardial effusion and a technique for bleeding control with LAA closure device deployment.

scholarly journals Management of Antithrombotic Therapy in Post Percutaneous Coronary Intervention Patient Undergoing Pericardiostomy due to Large Pericardial Effusion: A Case Report

2021 ◽  
Vol 2 (4) ◽  
pp. 40-44
Author(s):  
Dedy Irawan ◽  
Sasmojo Widito ◽  
Mohammad Saifur Rohman ◽  
Cholid Tri Tjahjono
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Case Report ◽  
Pericardial Effusion ◽  
Antithrombotic Therapy ◽  
Coronary Intervention ◽  
Adverse Cardiovascular Event ◽  
Bridging Therapy ◽  
Coronary Syndrome ◽  
Large Pericardial Effusion ◽  
Percutaneous Coronary

Background : Stent thrombosis is a serious complication following percutaneous coronary intervention (PCI), and dual antiplatelet therapy (DAPT) is necessary to avoid it. Surgery, on the other hand, is a common cause for stopping DAPT. Because patients were exposed to the possibility of a major adverse cardiovascular event (MACE) when DAPT was stopped, this circumstance poses a clinical dilemma. Objective : This case report aimed to describe the management of antithrombotic therapy in post PCI patient requiring DAPT who underwent pericardiostomy. Case : A 69-year-old woman with large pericardial effusion without cardiac tamponade, breast cancer on chemo- therapy, heart failure stage C NYHA functional class II, chronic coronary syndrome post-DES implantation at proximal-mid LAD, and hypertension. The patient underwent pericardiotomy procedures five days after DAPT discontinuation. For the bridging therapy, continuous UFH administration was initiated at a dose of 18 IU/kg/hour after the cessation of DAPT. The UFH dose was adjusted to achieve activated partial thromboplastin time (APTT) 1.5 to 2.0 times the control value. The UFH was discontinued 6 hours before surgery. After surgery, UFH infusion was restarted 6 hours after the confirmation of hemostasis. The administration of UFH then continued until three days after DAPT was restarted. No complications were found during and after the pericar- diostomy. Conclusion : We reported an antithrombotic treatment strategy in a post PCI patient undergoing pericardiostomy with discontinuation of DAPT, which was successfully treated with UFH without any complication. The UFH has been widely used in perioperative settings as a bridging therapy during the interruption of DAPT and may be considered in this condition.

scholarly journals Treatment of Common Femoral Artery Pseudoaneurysm: A Novel Approach Utilizing a VASCADE Percutaneous Closure Device

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mark Dalvin ◽  
Brandon Dessecker ◽  
Eugene Vitvitsky
Keyword(s):  
Case Report ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Percutaneous Closure ◽  
Closure Device ◽  
Thrombin Injection ◽  
Artery Pseudoaneurysm ◽  
Image Guided ◽  
Novel Technique ◽  
Novel Approach

Iatrogenic common femoral artery pseudoaneurysm is a well-known complication to vascular access. Many options, both surgical and nonsurgical, have been implemented as means to treat pseudoaneurysms such as thrombin injection, image-guided compression, and percutaneous closure devices. This case report demonstrates a novel technique using a VASCADE closure device to successfully treat an iatrogenic common femoral pseudoaneurysm.

scholarly journals Percutaneous Transgastric Duodenal Stenting and Gastrostomy Repair Using a Vascular Closure Device: Proof of Concept in a Porcine Model

2021 ◽  
pp. 155335062110310
Author(s):  
Eran Shlomovitz ◽  
Neeral R. Patel ◽  
Michele Diana ◽  
Radu Pescarus ◽  
Lee L. Swanström
Keyword(s):  
Porcine Model ◽  
Gastrostomy Tube ◽  
Closure Device ◽  
Leak Pressure ◽  
Proof Of Concept ◽  
Vascular Closure Device ◽  
Post Procedure ◽  
Vascular Closure Devices ◽  
Transgastric Access

Introduction. Gastroduodenal stenting is efficacious and safe in both benign and malignant foregut diseases. Transgastric duodenal stenting has been described and however requires a gastrostomy tube to remain in situ for 4 to 6 weeks post-procedure which can lead to complications. We present a technique for immediate gastric repair using a suture-mediated vascular closure device, without the need for a gastrostomy tube in porcine models. Methods. Percutaneous access into the stomach was achieved using fluoroscopy. Two or 3 Perclose Proglide devices were pre-deployed. The tract was dilated and a wire advanced into the distal duodenum. A 15.5 cm covered enteric stent was delivered through the gastrostomy, deployed and position confirmed. The gastrostomy was closed using Perclose Proglide sutures. Necropsy leak pressure measurement was performed to assess integrity of gastrostomy closure in the porcine models. Results. Two (n = 8) or 3 (n = 2) Perclose Proglide devices were deployed in ten porcine models, with 1 misfire (4.5%). Percutaneous transgastric access and stent delivery was successful in all porcine models. Mean leak pressure in the animals with adequately deployed devices was 219 mmHg (range 172 mmHg–270 mmHg). Conclusion. This study demonstrates percutaneous transgastric duodenal stenting with immediate gastric repair using suture-mediated vascular closure devices is a feasible procedure.

scholarly journals Clinic effect of angio-seal vascular closure device after coronary intervention

Heart ◽  
2011 ◽  
Vol 97 (Suppl 3) ◽  
pp. A167-A167
Author(s):  
W. Jun-Yuan ◽  
T. Sheng-xing ◽  
Z. Zheng-Cai ◽  
X. Chao-Hong ◽  
K. Yong-Sheng ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Closure Device ◽  
Vascular Closure Device

Management of Haemostasis with Combined Use of Vascular Closure Devices and Bivalirudin – A Review

2011 ◽  
Vol 6 (2) ◽  
pp. 177
Author(s):  
Emanuela de Cillis ◽  
Giuseppe Massimo Sangiorgi ◽  
Alessandro Santo Bortone ◽  
◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Closure Device ◽  
Vascular Closure Device ◽  
High Risk Patients ◽  
Vascular Closure Devices ◽  
Combined Use ◽  
Percutaneous Coronary ◽  
Risk Patients

Bleeding and vascular complications related to invasive cardiovascular procedures are associated with significant morbidity and mortality. The aim of this article is to evaluate the literature to determine haemostasis strategies in percutaneous coronary intervention when using bivalirudin with or without a vascular closure device. The literature data seem to underline that the combination of vascular closure devices and bivalirudin was associated with significantly lower bleeding rates. However, these strategies were less often used among high-risk patients. We recommend that prospective clinical studies are undertaken to determine the potential disadvantages of using vascular closure devices and bivalirudin in combination in high-risk patients.

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