title: Stent-grafts in the management of hemorrhagic complications related to hemostatic closure devices: report of two cases.
abstract: We report 2 cases of hemorrhagic complications related to use of the Angio-Seal hemostatic closure device that were successfully managed with stent-grafts. Two patients with subarachnoid hemorrhage were referred to our departments for endovascular treatment of ruptured intracranial aneurysms. The treatment was performed through a femoral access; the sheaths were removed immediately after the procedures, and the punctures sites closed by Angio-Seals. Both patients presented clinical signs of hypovolemic shock after treatment. The diagnosis of active bleeding through the puncture site was made by emergency digital subtraction angiography. The lesions were managed with stent-grafts. The use of stent-grafts proved to be efficient in the management of these life-threatening hemorrhagic complications following the use of the Angio-Seal hemostatic closure device.
authors.affiliation: Department of Interventional Neuroradiology, Fondation Rothschild, 25-29 rue Manin, 75940 Paris Cedex 19, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Giansante Abud
authors.forename: Charbel
authors.initials: C
authors.lastname: Mounayer
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Saint-Maurice
authors.forename: Marco Túlio Salles
authors.initials: MT
authors.lastname: Rezende
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Houdart
authors.forename: Jacques
authors.initials: J
authors.lastname: Moret
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction / Q000379:methods; D004864:Equipment and Supplies / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006489:Hemostatic Techniques / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000601:surgery*; D011677:Punctures / Q000009:adverse effects; D012769:Shock / Q000209:etiology; D015607:Stents; D016896:Treatment Outcome