title: Suture-mediated closure of antegrade femoral arteriotomy following infrainguinal intervention.
abstract: Antegrade femoral arterial access has been less commonly adopted for infrainguinal intervention due to increased risk of retroperitoneal hemorrhage secondary to noncompressibility of arteriotomy site. We evaluated the efficacy and safety of suture-mediated closure of antegrade femoral arteriotomy using the Closer device. Twelve consecutive patients undergoing infrainguinal intervention (females, 5; mean body weight, 69 +/- 16 kg; limb threatening ischemia, 50%) underwent repair of the antegrade femoral arteriotomy immediately postprocedure using the Closer. Indications for antegrade access were excessive iliac tortuosity (6/12), long femoral artery occlusion (5/12), and bilateral aortoiliac bifurcation stents (1/12). The acute procedural success (immediate hemostasis without need for manual compression) was 100%. The mean time to ambulation was 3.9 +/- 1.5 hr and the procedure-related length of stay was 18 +/- 5.5 hr. In conclusion, repair of antegrade arterial puncture is safe and effective following infrainguinal intervention.
authors.affiliation: Section of Cardiology and Endovascular Therapeutics, Mount Sinai Hospital, Chicago, Illinois 60608, USA. khos@sinai.org
authors.forename: Sandeep
authors.initials: S
authors.lastname: Khosla
authors.forename: Binu
authors.initials: B
authors.lastname: Kunjummen
authors.forename: Mayra
authors.initials: M
authors.lastname: Guerrero
authors.forename: Ravi
authors.initials: R
authors.lastname: Manda
authors.forename: Mansoor
authors.initials: M
authors.lastname: Razminia
authors.forename: Aziz
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery / Q000293:injuries* / Q000601:surgery*; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery*; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013997:Time Factors