scholarly journals Delayed Complication from a Percutaneous Vascular Closure Device following a Neuro-Interventional Procedure

2011 ◽  
Vol 17 (4) ◽  
pp. 495-500 ◽  
Author(s):  
A. Khaldi ◽  
B. Waldau ◽  
C. Skowlund ◽  
G.J. Velat ◽  
J. Mocco ◽  
...  
Keyword(s):  
Interventional Procedure ◽  
Limb Ischemia ◽  
Fistula Formation ◽  
Closure Device ◽  
Femoral Access ◽  
Jude Medical ◽  
Vascular Closure Devices ◽  
Increased Risk ◽  
Delayed Complication ◽  
Initial Procedure

Percutaneous vascular closure devices are being increasingly used as alternatives to manual compression for the closure of femoral arteriotomy after endovascular procedures as they appear to reduce time to ambulate, improve patient's comfort, and are implicated with cost saving. However, vascular closure devices have been associated with an increased risk of complications including hematoma formation, local bleeding, arteriovenous fistula formation, pseudoaneurysm and arterial leg ischemia. To our knowledge, if the above complications occur it is usually within the first 30 days after the procedure. None have been reported in a delayed fashion ten months or longer after closure. We describe a 30-year-old man with a history of a giant basilar trunk aneurysm. He was placed on aspirin and clopidogrel prior to the procedure. He had bilateral femoral access with 6 French sheaths. Following the procedure, 6 French Angio-Seals (St. Jude Medical, St. Paul, MN, USA) were used for closure of bilateral femoral arteriotomies. Ten months after the procedure, the patient kicked a metal cart and developed a large right retroperitoneal iliopsoas hematoma. There was no evidence of pseudoaneurysm. The patient was managed conservatively and his serial hematocrit stayed stable. He did not require surgical intervention. Use of percutaneous vascular closure devices is associated with complications including risk of hematoma, pseudoaneurysm, intravenous fistula, rectal peritoneal hemorrhage, limb ischemia and possible surgical repair. Most complications occur peri-procedure or within 30 days postprocedure. This is the first reported case of a delayed complication at ten months after the initial procedure. Site-related complications associated with percutaneous vascular closure devices may occur in a delayed fashion, even ten months postprocedure, so should be considered in the management of patients.

scholarly journals Usefulness of a Nonsuture Closure Device in Patients Undergoing Diagnostic Coronary and Peripheral Angiography

2017 ◽  
Vol 26 (04) ◽  
pp. 228-233
Author(s):  
John Owens ◽  
Shaun Bhatty ◽  
Robert Donovan ◽  
Andrea Tordini ◽  
Peter Danyi ◽  
...  
Keyword(s):  
Closure Device ◽  
Complication Rates ◽  
Manual Compression ◽  
Access Site ◽  
Femoral Access ◽  
Peripheral Angiography ◽  
Major Complications ◽  
Increased Risk ◽  
Male Patients ◽  
To Receive

AbstractVascular access site complications can follow diagnostic coronary and peripheral angiography. We compared the complication rates of the Catalyst vascular closure device, with the complication rates after manual compression in patients undergoing diagnostic angiographic procedures via femoral access. We studied 1,470 predominantly male patients undergoing diagnostic coronary and peripheral angiography. Catalyst closure devices were used in 436 (29.7%) patients and manual compression was used in 1,034 (70.3%) patients. The former were allowed to ambulate after 2 hours, while the latter were allowed to ambulate after 6 hours. Major complications occurred in 4 (0.9%) patients who had a Catalyst device and in 14 (1.4%) patients who had manual compression (odds ratio [OR]: 0.67, 95% confidence interval [CI]: 0.22–2.1, p = 0.49). Any complications occurred in 51 (11.7%) patients who had a Catalyst closure device and in 64 (6.2%) patients who had manual compression (OR: 2, CI: 1.4–3, p < 0.01). After adjustment for other variables and for a propensity score reflecting the probability to receive the closure device, the association of major complications with the use of the closure device remained not significant (OR: 0.54, 95% CI: 0.17–1.7, p = 0.29), while the association of any complications with the use of the Catalyst device remained significant (OR: 1.9, 95% CI: 1.3–2.9, p < 0.01). The Catalyst device was not associated with an increased risk of major groin complications but was associated with an increased risk of any complications compared with manual compression. Patients receiving the closure device ambulated sooner.

scholarly journals Percutaneous vascular closure device of the femoral access site after coronary interventions for acute coronary syndrome -immediate and short term follow-up

2017 ◽  
Vol 5 (3) ◽  
pp. 778 ◽  
Author(s):  
Ashraf Safiya Manzil ◽  
Sidharaj Vala ◽  
Sidharaj Vala
Keyword(s):  
Acute Coronary Syndrome ◽  
Interventional Procedure ◽  
Tertiary Care ◽  
Major Complication ◽  
Coronary Intervention ◽  
Closure Device ◽  
Short Term ◽  
Femoral Access ◽  
Coronary Syndrome

Background: Around 7 million patients undergo percutaneous interventional vascular procedures worldwide annually and this number is expected to escalate further in coming years. The aim of this study was to analyse immediate and short term follow up of patients with acute coronary syndrome (ACS) who had undergone percutaneous coronary intervention (PCI) through femoral route and closure with vascular closure device.Methods: This was non randomised, single centre study and was conducted in a tertiary care institution between January 2013 to June 2014 with 62 ACS patients undergoing femoral access invasive cardiac interventional procedure. Perclose A-T system was used in all patients as closure device. Patients were followed up to 15 days of clinical evaluation.Results: Of 62 ACS patients, 40 (64.5%) were with non-ST elevation myocardial infarction and 22 (35.5%) patients had history of unstable angina. The perclose device achieved closure within 5 to 10 minutes and all patients were kept in hospital stay for 2 to 3 days. There was one major complication of continuous bleeding, one incidence of small pseudo aneurysm, and two incidences of small hematomas with need of blood transfusion.Conclusions: This study demonstrates the ability of arterial closure device to safely and effectively achieve arterial closure in patients undergoing percutaneous intervention for ACS.

scholarly journals Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial

2020 ◽  
Author(s):  
Marianne Brodmann ◽  
◽  
Koen Deloose ◽  
Eric Steinmetz ◽  
Olivier Regnard ◽  
...  
Keyword(s):  
Closure Device ◽  
Peripheral Vascular ◽  
Primary Analysis ◽  
Access Site ◽  
Femoral Access ◽  
Vascular Closure Devices ◽  
Total Procedure Time ◽  
American Society ◽  
Device Use ◽  
Ambulatory Procedures

Abstract Purpose Ambulatory peripheral vascular interventions have been steadily increasing. In ambulatory procedures, 4F devices might be particularly useful having the potential to reduce access-site complications; however, further evidence on their safety and efficacy is needed. Materials and Methods BIO4AMB is a prospective, non-randomized mulitcentre, non-inferiority trial conducted in 35 centres in Europe and Australia comparing the use of 4F- and 6F-compatible devices. The main exclusion criteria included an American Society of Anaesthesiologists class ≥ 4, coagulation disorders, or social isolation. The primary endpoint was access-site complications within 30 days. Results The 4F group enrolled 390 patients and the 6F group 404 patients. Baseline characteristics were similar between the groups. Vascular closure devices were used in 7.7% (4F group) and 87.6% (6F group) of patients. Patients with vascular closure device use in the 4F group were subsequently excluded from the primary analysis, resulting in 361 patients in the 4F group. Time to haemostasis was longer for the 4F group, but the total procedure time was shorter (13.2 ± 18.8 vs. 6.4 ± 8.9 min, p < 0.0001, and 39.1 ± 25.2 vs. 46.4 ± 27.6 min, p < 0.0001). Discharge on the day of the procedure was possible in 95.0% (4F group) and 94.6% (6F group) of patients. Access-site complications were similar between the groups (2.8% and 3.2%) and included predominantly groin haematomas and pseudoaneurysms. Major adverse events through 30 days occurred in 1.7% and 2.0%, respectively. Conclusions Ambulatory peripheral vascular interventions are feasible and safe. The use of 4F devices resulted in similar outcomes compared to that of 6F devices.

Perclose ProGlide embolization as a complication: case report and review of literature

2021 ◽  
Author(s):  
Larab L Giniyani ◽  
Yesha P Rana ◽  
Balaram Krishna J Hanumanthu ◽  
Doris Chan ◽  
Tak W Kwan
Keyword(s):  
Aortic Aneurysm ◽  
Endovascular Procedures ◽  
Closure Device ◽  
Mechanical Compression ◽  
Review Of Literature ◽  
Femoral Access ◽  
Descending Aorta ◽  
Infrarenal Aortic Aneurysm ◽  
Important Complication ◽  
Vascular Closure Devices

Background: Vascular closure devices have replaced mechanical compression for closure of femoral access sites after endovascular procedures. Case: We present an 87-year old male with symptomatic infrarenal aortic aneurysm measuring 4.8 cm presenting for elective endovascular repair of the aortic aneurysm. A Perclose ProGlide Suture-Mediated Closure was used for closure. The closure was complicated by a separation of the ProGlide device resulting in the migration of the footplate to the descending aorta. Correction required snare retrieval via radial access, and the patient recovered without complications. Discussion: We highlight an important complication of the Perclose ProGlide Suture-Mediated Closure device that is rare but important to know when performing endovascular closures with this device.

Use of vascular closure devices for endovascular interventions requiring a direct puncture of PETE grafts

VASA ◽  
2018 ◽  
Vol 47 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Artur I. Milnerowicz ◽  
Aleksandra A. Milnerowicz ◽  
Marcin Protasiewicz ◽  
Wiktor Kuliczkowski
Keyword(s):  
Statistical Significance ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Inguinal Region ◽  
Closure Device ◽  
Manual Compression ◽  
Direct Puncture ◽  
Endovascular Interventions ◽  
Vascular Closure Devices ◽  
Closure Group

Abstract. Background: Effectiveness of vascular closure devices during endovascular procedures requiring a direct puncture of a vascular prosthesis placed in the inguinal region is unknown. Patients and methods: The retrospective analysis included 134 patients with a history of polyethylene terephthalate (PETE) graft implantation in the inguinal region. In 20 (15 %) patients, haemostasis was achieved with manual compression, in 21 (16 %) with the StarClose™, and in 93 (69 %) with the AngioSeal™ device. Results: The incidence of vascular complications in the manual compression group was higher (at a threshold of statistical significance) than in the device closure group (45.0 vs. 24.5 %, p = 0.059). The difference was considered statistically significant when manual compression was compared with the AngioSeal™ closure group (45.0 vs. 13.9 %, p < 0.01). The vascular complication rate in the StarClose™ group was significantly higher than in the AngioSeal™ group (71.4 vs. 13.9 %, p < 0.000001). While haematomas were the only vascular complications observed after application of AngioSeal™, both haematomas and pseudoaneurysms were found in the StarClose™ group. Conclusions: The AngioSeal™ vascular closure device provides better local haemostasis than the StarClose™ device or manual compression during endovascular interventions requiring a direct puncture of PETE grafts

Endovascular treatment of acute limb ischemia caused by an intravascularly deployed bioabsorbable plug of a vascular closure device

VASA ◽  
2013 ◽  
Vol 42 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Daniel Maxien ◽  
Barbara Behrends ◽  
Karla M. Eberhardt ◽  
Tobias Saam ◽  
Sven F. Thieme ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Limb Ischemia ◽  
Closure Device ◽  
Acute Limb Ischemia ◽  
Vascular Closure Device

Radial Versus Femoral Access With or Without Vascular Closure Device in Patients With Acute Myocardial Infarction

2019 ◽  
Vol 123 (5) ◽  
pp. 742-749 ◽  
Author(s):  
Namkyun Kim ◽  
Jang Hoon Lee ◽  
Se Yong Jang ◽  
Myung Hwan Bae ◽  
Dong Heon Yang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Closure Device ◽  
Vascular Closure Device ◽  
Femoral Access

S154 – Primary TEP and Patch Free-Flap Laryngectomy Reconstruction

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P128-P128 ◽  
Author(s):  
Tamer Abdel-Halim Ghanem ◽  
Justin McLarty ◽  
Farhad Ardeshirpour ◽  
Christopher F Baranano ◽  
Eben L Rosenthal ◽  
...  
Keyword(s):  
Free Flap ◽  
Total Laryngectomy ◽  
Demographic Data ◽  
Free Flaps ◽  
Fistula Formation ◽  
Increased Risk ◽  
Radial Forearm ◽  
Speech Therapist ◽  
Fistula Rate ◽  
Tracheoesophageal Puncture

Objectives 1. Assess speech outcomes for patients undergoing primary tracheoesophageal puncture (TEP) following total laryngectomy (TL) with patch free flap reconstruction. 2. Evaluate risk of fistulization following primary TEP vs. no TEP in patch free flap TL reconstruction. Methods Patients undergoing reconstruction with patch free-flaps following TL were studied retrospectively. Demographic data, surgical procedures, speech outcomes, and postoperative complications were collected. Patients were divided in 2 groups depending on whether TEP was performed at the time of ablation (primary TEP). Voice outcomes were assessed by a speech therapist. Results 77 patients underwent TL, mean age of 63 years. Glottis (60%), followed by hypopharynx (18%), and supraglottis (17%) were the most common tumor sites. Most patients had T3 and T4 disease (71%) on initial presentation, and there were 57% undergoing salvage total laryngectomy. The radial forearm fascioucutaneous free flap was used in 90% of the cases. Primary TEP was performed in 44 patients (57%), and only 1 of 33 patients underwent a TEP procedure secondarily. Voice outcomes for the TEP group were good. The overall fistula rate was 39%, half of which healed spontaneously. The fistula rate in the primary TEP group was 41%, and in the group not receiving primary TEP it was 36.7% (p=0.87). Conclusions Primary TEP performed at the time of free-flap patch reconstruction after TL enhances speech outcomes for patients, and does not lead to an increased risk in fistula formation.

scholarly journals Perkutaninio šlaunies arterijos kateterizavimo vietinių komplikacijų gydymo taktika

2014 ◽  
Vol 13 (3) ◽  
pp. 177-183
Author(s):  
Ingrida Ašakienė ◽  
Andrius Černauskas ◽  
Nerijus Misonis ◽  
Vaidotas Zabulis ◽  
Robertas Breivis ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Vascular Complications ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Treated Group ◽  
Suspected Coronary Artery Disease ◽  
Femoral Access ◽  
Artery Pseudoaneurysm ◽  
Access Complications ◽  
Local Vascular Complications

Darbo tikslas Nustatyti po intervencinių kardiologinių procedūrų per šlaunies arteriją susidariusių vietinių komplikacijų dažnį, pažeidimo vietos tipą ir optimalų gydymo metodą. Tyrimo medžiaga ir metodai Atlikta 166 pacientų, 2007–2011 metais patyrusių vietinių komplikacijų po kateterizavimo dėl įtariamos vainikinių arterijų patologijos, ligos istorijų duomenų retrospektyvi analizė. Vietinės kraujagyslių komplikacijos diagnozuotos ir gydytos krau­jagyslių chirurgų. Rezultatai Tiriamąją grupę sudarė 96 (57,8 %) moterys ir 70 (42,2 %) vyrų. Vidutinis pacientų amžius buvo 69,1 metų (±11,4 metai). 63 pacientams (38 %) nustatyta sutrikusi kojų arterinė kraujotaka. Po kateterizavimo, atlikto dėl širdies kraujagyslių sistemos pa­tologijos, šlaunies arterijos pseudoaneurizma išsivystė 162 (97,6%), arterioveninė fistulė – 3 (1,8 %), didelė hematoma – 1 pa­cientui. 111 (66,9 %) pacientų gydyta konservatyviai. Chirurginio gydymo prireikė 55 (33,1 %) pacientams. Operuotos 37 mo­terys (67,3 %) ir 18 vyrų (32,7 %). Vidutinis operuotų pacientų amžius buvo 69,9 (±10) metai. Pseudoaneurizmos pašalinimas ir arterijos plastika venos lopu atlikta 33 (60 %) pacientams, pašalinti krešuliai ir užsiūti arterijos defektai 22 (40 %) pacientams. Išvados Vietinių kraujagyslių komplikacijų po intervencinių kardiologinių procedūrų per šlaunies arteriją įvyko 166 pacientams (0,706 %). Dažniausia komplikacija po šlaunies arterijos kateterizavimo – pseudoaneurizma. Pseudoaneurizmos sėkmingai gydytos konservatyviai 111 pacientų (66,9 %). Punkcijos vietos kraujagyslių komplikacijos buvo dažnesnės ligoniams, ku­riems buvo periferinių arterijų aterosklerozinis pažeidimas (p<0,01). Reikšminiai žodžiai: jatrogeninis šlaunies arterijos pažeidimas, pseudoaneurizma Treatment of local complications that develop after catheterisation through the femoral artery punctureIngrida Ašakienė, Andrius Černauskas, Nerijus Misonis, Vaidotas Zabulis, Robertas Breivis, Sigitas Tvarionavičius, Ramūnas Kvietkauskas ObjectiveTo determine what is the rate, type, and the best treatment of local femoral access complications after interventional cardiol­ogy catheterisation procedures through percutaneous femoral artery puncture.Materials and methodsRetrospective analysis of 166 patient medical records was carried out. All the patients underwent coronarography for the suspected coronary artery disease. All of them from 2007 to 2011 developed local femoral access complications. All complica­tions were diagnosed and treated by vascular surgeons.ResultsThe study group consisted of 96 (57.8%) women and 70 (42.2%) men. The average age of the patients was 69.1 years (±11.4 years). Limb ischemia was determined in 63 patients (38%). After catheterisation due to cardiovascular pathology, femoral artery pseudoaneurysm developed in 162 patients (97.6%), arteriovenous fistula in 3 patients (1.8%), and massive hematoma in 1 patient; 111 patients (66.9%) were treated conservatively and 55 (33.1%) surgically. The surgically treated group consisted of 37 women (67.3%) and 18 men (32.7%). The average age of surgically treated patients was 69.9 (±10) years. Pseudoaneurysm removal and venous patch plasty were performed in 33 patients (60%). The removal of blood clots and direct suture of arterial defects were performed in 22 patients (40%).Conclusions166 patients (0.706%) developed local vascular complications after cardiovascular interventions through the femoral artery. Pseudoaneurysm was the most common complication after femoral artery catheterisation. Conservative treatment was suc­cessful in 111 patients (66.9%). Local vascular complications of the puncture site were more common in patients with a pe­ripheral arterial disease (p < 0.01).Key words: iatrogenic femoral artery damage, pseudoaneurysm

Sign in / Sign up

Export Citation Format

Share Document