Closure of Carotid Artery Puncture Site With a Percutaneous Device

Massière, Bernardo; Ristow, Arno von; Cury, José Mussa; Gress, Marcus; Vescovi, Alberto; Pedron, Cleoni; Medina, Antonio Luiz de; Masques, Marcos Areas; Silveira, Paulo Roberto Mattos da; Jeha, Salim Abdon Haber

doi:10.1016/j.avsg.2008.06.014

Cited by 13 publications

(5 citation statements)

References 14 publications

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“…Other reports are compatible with our results [12,17-19]. Blanc et al [18] found complications (cervical hematoma, small aneurysm and puncture-related vasospasm, and thrombus formation) in six of 42 patients (14%) encountered after performing manual compression of the access site.…”

Section: Discussionsupporting

confidence: 93%

Alternative Transcarotid Approach for Endovascular Treatment of Acute Ischemic Stroke Patients: A Case Series

Styczen¹,

Behme²,

Hesse³

et al. 2019

Neurointervention

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Mechanical thrombectomy has become the standard of care for acute stroke caused by large vessel occlusion. As more patients are treated endovascularly, the number of older patients with tortuous vessels has risen. In these patients, catheterizing the internal carotid artery via a transfemoral approach can be very difficult or even impossible. Therefore, in selected patients, alternative strategies to the transfemoral approach have to be applied. Materials and Methods: We report a case series of six patients undergoing mechanical thrombectomy via a combined transfemoral and transcarotid approach. Puncture of the carotid artery was conducted using roadmap guidance after an unsuccessful transfemoral attempt. Technical aspects and outcomes with this alternative approach were analyzed. Results: Direct puncture of the carotid artery was achieved in five out of six patients (83%). In three out of six patients (50%), revascularization (modified Thrombolysis in Cerebral Infarction score ≥2b) was restored. No complications related to endovascular therapy were documented. One patient showed good neurological outcome (modified Rankin Scale [mRS] 5 at admission, mRS 1 at discharge). Conclusion: A combined transfemoral/transcarotid approach can be an alternative vascular access in patients with problematic vessel anatomy.

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Section: Discussionsupporting

confidence: 93%

Alternative Transcarotid Approach for Endovascular Treatment of Acute Ischemic Stroke Patients: A Case Series

Styczen¹,

Behme²,

Hesse³

et al. 2019

Neurointervention

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“…Data regarding the use of Angioseal TM for closure of carotid puncture is sparse and there are a few reports describing its use. 1,7,8 Recently, the use of StarClose (Abbott Vascular, Abbott Park, Illinois, USA) has been described in two patients with good results. 4 In this article, we describe our experience with the use of Angioseal for closure of direct carotid puncture in eight patients with follow-up imaging.…”

Section: Introductionmentioning

confidence: 99%

Angioseal™ as a hemostatic device for direct carotid puncture during endovascular procedures

et al. 2015

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Introduction Direct carotid artery puncture (DCP) is employed in patients with tortuous anatomy and peripheral vascular disease when the peripheral arteries are not available for vascular access. Manual compression is the only method of achieving hemostasis following DCP and, till date, the use of a closure device for DCP has been reported in only one patient. In this study we sought to analyze our experience with the use of closure device for DCP. Methods This is a retrospective study of patients in whom Angioseal™ was used following DCP for neuroendovascular procedures. Medical charts and imaging of these patients was reviewed for any abnormalities pertaining to the use of the closure device. Results A total of eight patients were included in the study. Angioseal™ was used in all the patients. There were no complications related to the use of the closure device in any of the eight patients. Immediate post-procedure angiography done in one patient did not show any structural or hemodynamic abnormalities within the carotid artery lumen. At 6 months follow-up imaging, there was no evidence stenosis or vascular wall abnormality in any of the patients. There were no adverse clinical reactions related to the use of closure device. Conclusion In our experience, Angioseal™ may be a safe and off-label effective closure device for patients undergoing DCP for neuroendovascular procedures. It obviates the need for manual compression without causing any structural or hemodynamic changes within the carotid artery. Larger studies with longer follow-up are required to establish its safety in patients undergoing DCP.

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“…Despite the fact that the use of VCDs in extrafemoral arteries is only anecdotally reported, there are few small retrospective series suggesting that VCDs are probably the best way to handle such a complication [13][14][15], thus avoiding the potentially dangerous ''pull and compress'' technique, which is associated with an increased morbidity and mortality rate [5].…”

Section: Discussionmentioning

confidence: 98%

Erroneous placement of central venous catheter in the subclavian artery: Retrieval and successful hemostasis with a femoral closure device

Schütz

Doll

Bonvini

2010

Cathet Cardio Intervent

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Central venous catheter (CVC) placement, even if performed under duplex scan control, may be associated with incidental arterial injury leading to increased morbidity, mortality, and prolonged hospital stay. Erroneous CVC placement in the carotid or subclavian arteries has been usually treated surgically because those puncture sites may not be efficaciously compressed manually. However, surgery in this setting may be challenging because of difficulty of access for the catheters positioned in the subclavian artery and of the risk of cerebrovascular complications for carotid catheters. Recently, several cases have been published, describing the successful endovascular management of iatrogenic arterial injury using different types of vascular closure devices (VCD). However, in this setting, it remains difficult to be completely sure that the VCD has achieved complete hemostasis and that the patient does not subsequently incur in a clinically silent intrathoracic bleeding. We report the case of an erroneous CVC placement in the right subclavian artery successfully retrieved using an Angioseal VCD. The immediate and complete hemostasis at the puncture site was confirmed at angiography.

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Closure of Carotid Artery Puncture Site With a Percutaneous Device

Cited by 13 publications

References 14 publications

Alternative Transcarotid Approach for Endovascular Treatment of Acute Ischemic Stroke Patients: A Case Series

Alternative Transcarotid Approach for Endovascular Treatment of Acute Ischemic Stroke Patients: A Case Series

Angioseal™ as a hemostatic device for direct carotid puncture during endovascular procedures

Erroneous placement of central venous catheter in the subclavian artery: Retrieval and successful hemostasis with a femoral closure device

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