A Novel Intervention to Treat Failed Angio-Seal Footplate Deployment: Two Case Series

Hall, Thomas C.; Habib, Said

doi:10.1177/1179547619828714

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Although it was thought that stenting across the hip joint may result in stent fracture and occlusion recent studies have concluded that CFA stenting can be safely performed without any significant increase in risk of stent fracture. [ 9 , 10 ] If the patient presents late with CFA occlusion or stenosis, that is the stage when the device is resorbed and there is fibrosis then treatment can be surgical (endarterectomy requiring patch angioplasty) or endovascular (angioplasty) after discussion in a multidisciplinary meeting. [ 11 ] Distal embolization is unique to Angio-Seal device and is a rare complication.…”

Section: Discussionmentioning

confidence: 99%

Complications with the use of Angio-Seal vascular closure device and their management

Shariq,

Premnath,

Saleh

et al. 2023

JCIS

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Vascular closure devices (VCDs) are being increasingly used for achieving hemostasis after diagnostic and therapeutic endovascular procedures. Although uncommon, complications may be encountered which are associated with the use of these VCDs. We report four cases where the use of Angio-Seal (Terumo, Somerset, New Jersey, USA) was followed by complications. Three cases presented with acute limb ischemia, among them, two patients had arterial occlusion at the vascular access site and one patient had embolization of the footplate anchor of the closure device. One case presented with pseudoaneurysm at the common femoral artery access site along with occlusion at origin of the superficial femoral artery. We have described the mechanism in which these complications occur and the successful management of these cases preventing potential amputation and limb loss. The risk factors which increase the risk of complications with the use of Angio-Seal VCD were reviewed and the strategy to avoid these complications with particular emphasis on the utility of ultrasound when using Angio-Seal VCD is discussed. A strategy to manage these complications has been discussed while deciding on endovascular management or surgical management, especially in patients with challenging presentation and those with multiple comorbidities making them at very high risk for surgery.

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Section: Discussionmentioning

confidence: 99%

Complications with the use of Angio-Seal vascular closure device and their management

Shariq,

Premnath,

Saleh

et al. 2023

JCIS

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An update on the use of an arterial closure device following femoral arterial puncture in children

et al. 2019

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A novel bailout technique using myocardial biopsy forceps to grasp a dislodged angio-seal collagen with footplate

Miwa,

Hayakawa,

Tsuchida

et al. 2024

CVIR Endovasc

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Background Hemostatic devices are now frequently used in femoral artery punctures, and the Angio-Seal (Terumo, Tokyo, Japan) is one of the most commonly used devices for closure of the femoral artery because it provides rapid hemostasis. Although device failure rarely occurs, if the collagen falls into the femoral artery, it may lead to severe limb ischemia. Herein, we describe a case of a novel endovascular technique for the treatment of Angio-Seal arterial closure device failure. Case presentation The patient in Case 1 was a 75-year-old man with severe left limb claudication. We used a contralateral antegrade approach and used the Angio-Seal for hemostasis. However, the Angio-Seal collagen and footplate dropped and stopped at the bifurcation of the superficial femoral artery and deep femoral artery. The collagen with the footplate was caught with myocardial biotome forceps (MBF) and pulled into the external iliac artery (EIA). The distal common femoral artery (CFA) was punctured, and we delivered a 10.0- × 80-mm stent (SMART®; Cordis, USA) to the EIA from the ipsilateral sheath. The stent was deployed at the EIA and crushed the collagen. The patient in Case 2 was an 88-year-old man with rest pain in the right limb. The right CFA was punctured using an ipsilateral approach and the Angio-Seal was used for hemostasis. The Angio-Seal collagen with the footplate dropped into the bifurcation of the deep femoral artery. The collagen and footplate were caught with MBF and pulled up to the EIA. The right CFA was punctured and a 10.0- × 60-mm stent (SMART®; Cordis) was delivered from the ipsilateral sheath. The stent was deployed at the EIA and crushed the collagen with the footplate. Conclusions MBF were used to grasp the dislodged collagen with the anchor and cover it with a stent at the iliac artery. This may be a useful bailout technique for Angio-Seal dislodgement.

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A Novel Intervention to Treat Failed Angio-Seal Footplate Deployment: Two Case Series

Cited by 3 publications

References 16 publications

Complications with the use of Angio-Seal vascular closure device and their management

Complications with the use of Angio-Seal vascular closure device and their management

An update on the use of an arterial closure device following femoral arterial puncture in children

A novel bailout technique using myocardial biopsy forceps to grasp a dislodged angio-seal collagen with footplate

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