A Novel Technique to Retrieve a Maldeployed Vascular Closure Device

Abstract

Endovascular retrieval of an embolized Angio-Seal device can be done using an embolic filter device, restoring arterial flow to the limb.

Endovascular Management of Superficial Femoral Artery Occlusion Secondary to Embolization of Celt ACD® Vascular Closure Device

“…Suture-mediated VCDs, in particular, are associated with a high risk of failure compared with other device sub-types [ 4 ]. On the contrary, plug-based and clip-based devices are associated with a higher risk of ischemic complications due to the distal embolization of the intraluminal component [ 5 ].…”

“…A standard conventional surgical embolectomy has been traditionally performed to manage distal device embolization [ 7 , 8 ]. However, more recent endovascular approaches have challenged the traditional surgical approach, with promising results being reported [ 5 , 9 , 10 ].…”

“…Upon discovery of the embolization of a VCD during deployment, it should be immediately managed either by endovascular snaring or open surgical retrieval [ 1 , 5 , 9 ]. However, symptomatic chronic embolization should be managed either by angioplasty or open surgical repair, as there is no chance for endovascular retrieval since the device will be embedded in the wall, possibly due to endothelialization and intimal hyperplasia.…”

Successful surgical retrieval of Celt ACD® vascular closure device embolised in the tibioperoneal trunk

“…On the other hand, ischemic complications have been found to be more common in devices which employ an intraluminal component such as Celt ACD® and Angio-Seal® (St. Jude Medical, Inc., St. Paul, Minn). This is due to the higher risk of distal embolisation of the intraluminal component (Suri et al 2015).…”

“…In cases of distal embolisation of VCDs, open surgical embolectomies have conventionally been carried out to retrieve the mal-deployed device (Prabhudesai and Khan 2000; van der Steeg et al 2009). However, cases of successful retrieval of embolised Angio-Seal® devices through endovascular approaches have been reported (Suri et al 2015; Jud et al 2017). The successful endovascular retrieval of a distally embolised Celt ACD®, following primary device failure, was reported by Cahill et al (Cahill et al 2013).…”