Surgical treatment of arterial ischemia associated with the use of the angioseal vascular closure device

Abstract

Surgical repair is effective, although, generally, it is not restricted to a simple thrombectomy, requiring the use of different arterial repair techniques.

Control of local haemostasis with the AngioSeal® vascular closure device in peripheral endovascular interventions via 6-9 F femoral artery access

“…The symptoms were milder and eventually resolved with the end of biodegradation of the intravascular elements of the AngioSeal ® device. The patient did not require interventional treatment [6]. Most of the studies report similar to ours frequency of local complications for the AngioSeal® device such as large subcutaneous haematoma, pseudoaneurysm, arteriovenous fistula, and limb ischaemia in comparison to the use of classic compression dressing [3,[12][13][14][15][16][17][18].…”

“…The patient underwent a successful surgical procedure and did not present symptoms of ischaemia during subsequent observation [10]. Less severe symptoms of ischaemia including claudication of the lower limb after the AngioSeal ® device implantation were also described [6]. In this case the patient remained under ambulatory follow-up because of the lack of symptoms of severe ischaemia.…”

“…In the case of surgery, a vascular surgeon should pay special attention while operating in the proximity of the AngioSeal ® device implanted into the femoral artery to avoid involuntary translocation of the device elements, which can lead to severe complications including limb ischaemia, as demonstrated in the case described by Ponton et al [6]. Trans radial access is currently considered as a safer approach leading to lower frequency of bleeding complications and it is used with increasing frequency for coronary interventions [26].…”

“…Several cases of acute and chronic limb ischaemia related to the AngioSeal® device implantation have been described previously. These occurred after implantation of the device in the atherosclerotically changed vessel or in the superficial femoral artery, after dissection of the atherosclerotic plaque or after thrombosis leading to occlusion of the artery [4][5][6][7][8][9]. In some cases a collagen plug was found intra-operatively in the lumen of the superficial femoral artery [4,10].…”

“…In some cases a collagen plug was found intra-operatively in the lumen of the superficial femoral artery [4,10]. These patients required percutaneous [11] or surgical [4][5][6] interventions due to limb ischaemia. All of the procedures succesful and no symptoms of ischaemia were observed during follow-up were reported.…”