The in vitro and in vivo ultrasonographic appearances of the angio-seal percutaneous closure device.
OBJECTIVE
To assess the ultrasound appearances of the Angio-Seal device in an animal model and in twenty patients following catheterization of the femoral artery.


METHODS
Ten patients were scanned within 8 hours of their procedure (early group) and 10 at two to four days (delayed group) using Acuson Aspen and Sequoia scanners. Colour flow images were taken and Doppler spectral analysis was performed proximal proximal to, at and distal to the Angio-Seal device. Early and delayed in vitro images were taken in a water bath in which the Angio-Seal device was deployed across a normal porcine aorta for comparison.


RESULTS
In the ten early patients colour and Doppler drop out were seen in 100 percent and 90 percent respectively compared with 90 percent and 60 percent in the delayed group. The device was seen in 30 percent and 90 percent in early and delayed groups respectively. In the in vitro study the components of the device were seen and a posterior acustic shadow noted. This shadow was less obvious and the polymer anchor more easily seen in the delayed group.


CONCLUSIONS
The Angio-Seal device produces a consistent artifact when scanned soon after deployment. These appearances could potentially be mistaken for a vascular occlusion by the unwary in the appropriate clinical setting of acute post catheterisation lower limb ischaemia however an awareness of the normal sonographic appearances of this device would make this misinterpretation unlikely.
Corkill
R A
RA
The Department of Radiology, Derriford Hospital, Plymouth, Devon PL6 8DH, UK.
Hughes
P M
PM
Elford
J C C
JC
Roobottom
C A
CA
D020341:Absorbable Implants; D000792:Angiography / Q000009:adverse effects; D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D016477:Artifacts; D003094:Collagen / Q000627:therapeutic use*; D005263:Femoral Artery / Q000601:surgery; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D066298:In Vitro Techniques; D023421:Models, Animal; D012039:Regional Blood Flow; D013552:Swine; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*
D003094:Collagen