An 83-year-old female patient with a history of prior endovascular treatment to repair an abdominal aortic aneurysm presented with intense pain and edema in the left leg, with hyperemia and localized temperature increase. Doppler ultrasonography revealed a voluminous aneurysm of the popliteal artery with a contained rupture, and hematoma involving the popliteal fossa and the medial and anterior surfaces of the knee causing compression of the popliteal vein. Endovascular repair was accomplished with covered stents and the rupture was confirmed. during the procedure The aneurysm was excluded and the signs and symptoms it had caused resolved completely, but during the postoperative period the patient developed sepsis of pulmonary origin and died.

Background: Vascular closure devices (VCD) make it possible to rapidly remove the introducer sheath from an arterial access, thereby reducing the length of time in hemostasis, the time patients are restricted to their beds, and the number of puncture site complications. Objectives: To evaluate the efficacy and possible complications associated with use of an arterial occlusion device compared with manual compression. Methods: This was a prospective, randomized, longitudinal study of 20 patients conducted from December 2014 to July 2015 in Maringá, PR, Brazil. They were divided into two groups: those who were treated using a VCD (VCD group) and those for whom only manual compression was used (MC group). Doppler ultrasound examination was used to determine skin-artery depth before and after the procedure and the length of time compression was maintained and the delay before mobilization were also recorded. Data were analyzed using the program Statistical Analysis Software. Results: A total of 60% of the patients were male and the mean age of both groups was approximately 60 years. There was no difference in skin-artery depth between the groups. The duration of compression in the VCD group was 2 minutes and in the MC group it was 21±2.11 minutes (p = 0.0005), while the delay before return to mobility of the lower limb that had been punctured was 2.35±0.75 hours in the VCD group and 6 hours in the MC group (p = 0.0005). There were no complications. Conclusions: In this study, hemostasis by manual compression exhibited equal efficacy to use of a VCD, but the duration of compression and delay before resumption of activity were shorter in the patients for whom the device was employed.