title: Infectious and ischemic complications from percutaneous closure devices used after vascular access.
abstract: The introduction of percutaneous closure devices (PCDs) to seal arteriotomy sites following percutaneous vascular access (PVA) can lead to greater complications than those with manual compression. The aim of this study was to compare complications and outcome between patients requiring surgery after receiving a PCD and those undergoing standard manual compression. This retrospective study evaluated 56 patients (mean age, 63 years) requiring surgical intervention from January 1, 1998 to April 30, 2002, following complications of PVA. Operative indications were pseudoaneurysm, hemorrhage, infectious complications, and limb ischemia. Patients were divided into two groups for comparison: group I (n = 15, PCD) and group II (n = 41, no PCD). In group 1 patients there were 18 limbs in which 20 Perclose devices were used and 1 limb in which a Duett device was used. From the outcomes in these two groups we concluded that patients undergoing surgical intervention following complications of PVA are at a significantly increased risk for infectious and ischemic complications and require more complex vascular repair when percutaneous closure devices are used.
authors.affiliation: Division of Vascular Surgery, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors.forename: Umar S
authors.initials: US
authors.lastname: Boston
authors.forename: Jean M
authors.initials: JM
authors.lastname: Panneton
authors.forename: Janet M
authors.initials: JM
authors.lastname: Hofer
authors.forename: Enrique A
authors.initials: EA
authors.lastname: Sabater
authors.forename: Noel
authors.initials: N
authors.lastname: Caplice
authors.forename: Charles M
authors.initials: CM
authors.lastname: Rowland
authors.forename: Audra A
authors.initials: AA
authors.lastname: Noel
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Bower
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Cherry
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology; D001808:Blood Vessels / Q000293:injuries; D005121:Extremities / Q000098:blood supply; D005260:Female; D006488:Hemostasis, Surgical / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011677:Punctures / Q000009:adverse effects*; D012086:Reoperation; D012189:Retrospective Studies; D013537:Sutures