Sheath pulling immediately after PTCA: Comparison of two different deployment techniques for the hemostatic puncture closure device: A prospective, randomized study

Silber, Sigmund; Dörr, R.; Mühling, Holger; König, U.

doi:10.1002/(sici)1097-0304(199708)41:4<378::aid-ccd5>3.0.co;2-2

Cited by 29 publications

(13 citation statements)

References 33 publications

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“…14,18,40 Several comparative studies analyzing Angio-Seal vs manual compression reported shorter time to hemostasis and ambulation in patients treated with the Angio-Seal device. [42][43][44] A randomized trial comparing Angio-Seal with MC showed reduced time to hemostasis and earlier ambulation in the Angio-Seal group despite anticoagulation as well as reduced complication. 45 In another randomized study comparing Angio-Seal to fem-stop device, the early benefit of Angio-Seal in the first 2 hours with reduced local groin complication was lost at 24 hours.…”

Section: Clinical Experience With Vascular Closure Devicessupporting

confidence: 85%

“…46 Inadvertent deployment of an intraluminal collagen plug can lead to femoral artery occlusion, which is a major complication with a reported incidence ranging from 0.8% to 3.6%. [35][36][37][38][39][40][41]43,44 One can reduce this potential complication by avoiding placement of the Angio-Seal device in arteries less than 5 mm in diameter or in arteries with significant circumferential calcification or thrombus which may compromise the flow lumen. As with all percutaneous closure devices, the deployment of the Angio-Seal device in the common femoral artery can ensure the highest likelihood of clinical success.…”

Section: Clinical Experience With Vascular Closure Devicesmentioning

confidence: 99%

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Access site management with vascular closure devices for percutaneous transarterial procedures

Bechara

Annambhotla

Lin

2010

Journal of Vascular Surgery

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The rising numbers in the aging population will undoubtedly lead to a corresponding increase in percutaneous endovascular procedures to address their cardiovascular health issues. With a constant drive to develop innovative treatment methods to achieve improved treatment outcomes while reducing procedural-related complications, endovascular interventionalists have focused on technologies to provide efficient hemostatic control of femoral artery access following percutaneous diagnostic or therapeutic angiographic procedures. Compared with the traditional hemostatic method using manual compression, several arterial closure devices (ACD) have been shown to reduce time of hemostasis, enable early patient ambulation, reduce hospitalization staff use, and improve patient outcome. However, these ACDs have their shortcomings as the interventionalists need to be familiar with these technologies as well as their potential complications. This article provides a comprehensive review of current closure device technologies as well as clinical experiences with these devices. The adjunctive role of these technologies in endovascular aortic aneurysm repair is also discussed.

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Section: Clinical Experience With Vascular Closure Devicessupporting

confidence: 85%

Section: Clinical Experience With Vascular Closure Devicesmentioning

confidence: 99%

Access site management with vascular closure devices for percutaneous transarterial procedures

Bechara

Annambhotla

Lin

2010

Journal of Vascular Surgery

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“…Sherwood); hierbei wird ein resorbierbarer "Anker" intraarteriell eingebracht und dient als Führung für das dann supraarteriell zu plazierende Kollagen (9). In mehreren Single-und Multicenter-Studien wurde die Effizienz und Sicherheit dieses Systems dokumentiert (4,11,15,17,18). Bislang sind uns aber keine Publikationen bekannt, die bei Verwendung dieses Systems die Möglichkeit einer intraluminalen Applikation mit nachfolgendem Gefäßverschluß dokumentierten.…”

Section: Inadvertent Occlusion Of the Common Femoral Artery Followingunclassified

Akzidenteller Verschluß einer A. femoralis communis nach Angio-Seal TM -Applikation

Silber¹,

Schön²,

Seidel³

et al. 1998

Zeitschrift f�r Kardiologie

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Removal of the arterial sheath immediately after PTCA is desirable for patients, reduces the medical staff's workload, and may decrease hospital costs due to a shortened length of stay. Although the safety and efficacy of the hemostatic systems used especially for the above purpose have been sufficiently documented, inadvertent intraluminal vascular occlusion is theoretically possible. While partial or complete arterial occlusion in conjunction with the VasoSeal collagen prototype device has been previously reported, similar complications occurring with the Angio-Seal device were not published. In this report, we describe a 54-year old female patient (height: 150 cm, weight: 42.5 kg) who was transferred for PTCA following an acute anterior wall myocardial infarction. Immediately after PTCA, the Angio-Seal device was deployed utilizing standard technique. No difficulties were encountered during device deployment, however, immediately following device placement active arterial bleeding occurred. Due to the inadequacy of hemostasis, heparin was reversed with protamine to avoid further hemorrhagic complications. Following this, the desired hemostasis quickly occurred, but the patient soon complained about symptoms suggestive of an acute occlusion of the right femoral artery. Unsatisfactory attempts at lysis resulted in the patient being transferred to vascular surgery. The complete Angio-Seal system (anchor including collagen) was located intravascularly, and removed during surgery. This case report demonstrates that even an experienced examiner can inadvertently deploy the Angio-Seal completely intraarterially. In addition to the known contraindication, "peripheral arterial occlusive disease", we recommend that the Angio-Seal device not be utilized in patients of small physical size.

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“…The principles of this technique have been described elsewhere [2,3]. In 2 patients, we found it impossible to insert an 8F Prostar Plus device retrogradely and a 6F Techstardevice antegradely into the external iliac artery and superficial femoral artery, respectively.…”

Section: Technical Procedures Descriptionmentioning

confidence: 99%

“…Several groups have described the use of percutaneous arterial closure devices to obtain hemostasis [2,3]. The use of these devices is difficult or impossible in patients with considerable scar tissue at the arterial access site due to previous operations or numerous percutaneous procedures.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous arterial closure in severely scarred groins: A technical note

Winter

Khalighi

Claussen

et al. 1998

Cathet. Cardiovasc. Diagn.

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Sheath pulling immediately after PTCA: Comparison of two different deployment techniques for the hemostatic puncture closure device: A prospective, randomized study

Cited by 29 publications

References 33 publications

Access site management with vascular closure devices for percutaneous transarterial procedures

Access site management with vascular closure devices for percutaneous transarterial procedures

Akzidenteller Verschluß einer A. femoralis communis nach Angio-Seal TM -Applikation

Percutaneous arterial closure in severely scarred groins: A technical note

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