An evaluation of immediate sheath removal and use of the Angio-Seal vascular closure device in neuroradiological interventions.
We set out to assess the effect of using an arteriotomy closure device in patients at high risk of access site complications. One-hundred nineteen patients with femoral artery access were prospectively included in five centers in France (56 males, 63 females, age range 20-84 years). The neurointerventional procedures were embolization of intracranial aneurysm (71.4%), carotid angioplasty (11.8%), cerebral angioplasty (1.7%), thrombolysis (0.8%), and other procedures (14.3%). Sheaths were removed and the closure device deployed immediately postprocedure. One patient developed a false aneurysm, and one developed a small hematoma. Neither required treatment. Postdevice deployment bleeding was experienced in three patients (2.5%), requiring minimal management. There were no major complications. Three patients died of causes unrelated to the vessel closure. Patient comfort was 2.2 on a scale of 1 (none) to 10 (severe). The results showed that immediate sheath removal followed by use of the closure device is safe in patients undergoing neurointerventional procedures and offers a low level of patient discomfort. In selected patients, early hospital discharge was possible.
Pierot
L
L
Department of Radiology, Hôpital Maison Blanche, Reims, France.
Herbreteau
D
D
Bracard
S
S
Berge
J
J
Cognard
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D005263:Femoral Artery; D005602:France; D006489:Hemostatic Techniques / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011677:Punctures / Q000009:adverse effects; D015641:Radiography, Interventional; D011795:Surveys and Questionnaires