Perclose Proglide Embolization As a Complication: Case Report and Review of Literature

Abstract

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.

Inadvertent Insertion of Hemodialysis Catheter into Brachiocephalic Trunk During Cannulation of Internal Jugular Vein: Management Strategies

“…7 An extensive search of literature regarding the incidence of breakage and embolism of Perclose devices yielded only two results. 8,9 In both the cases, the embolized device could be retrieved with snare, without any complication. Jahromi et al have reported thromboembolic stroke after percutaneous treatment of inadvertent subclavian artery placement of a CVC.…”

Watchman Device Procedure Complicated by Rare Perclose ProGlide Embolization: Case Report and Literature Review

“…Embolization of intravascular foreign bodies poses many risks for our patients including the development of perforation, septic complications, thrombosis, and obstruction in blood flow [ 10 ]. In the previous two cases of Perclose ProGlide embolizations, a snare retrieval approach was used to manage this complication [ 5 , 9 ]. In our case, the patient needed to go to the operating room emergently.…”

“…The Watchman device (Boston Scientific Corporation, Marlborough, Massachusetts, United States) works by closing the LAA so the procedure serves as a promising, safe, and effective alternative to OAC, overcoming disadvantages including the risk of major bleeding. Vascular closure devices (VCDs) like Perclose ProGlide™ Suture-Mediated Closure System (Abbott Laboratories Inc., Chicago, Illinois, United States) have largely replaced the use of mechanical compression in managing femoral access after Watchman device procedures [ 5 ]. The device has demonstrated excellent safety.…”

Comparison of Suture-Based and Collagen-Based Vascular Closure Devices for Large Bore Arteriotomies—A Meta-Analysis of Bleeding and Vascular Outcomes

“…Where in S-VCD, failure can be due to suture tear or incomplete apposition of highly calcified walls, toggle-plug malapposition due to calcium can lead to failure of C-VCD [ 19 ]. On the similar terms, both categories of devices may lead to other complications including distal embolization of the plug (in C-VCD) or foot plate (in S-VCD) and can also lead to infections of the arterial or access site [ 39 , 40 , 41 ]. Some of these factors may be non-modifiable, such as age and gender, but the introduction of intravascular lithotripsy facilitated transfemoral TAVR [ 42 , 43 ] or the reduction in sheath sizes with newer devices [ 44 ] may play important roles in the reduction of poor outcomes in LBA and further delineate any differences in the outcomes of these two VCDs.…”