title: Treatment of an Angio-Seal-related vascular complication using the SilverHawk plaque excision system: a case report.
abstract: The Angio-Seal is a user-friendly and safe arterial closure device increasingly used after percutaneous diagnostic and interventional procedures. Although it achieves rapid hemostasis and facilitates early patient mobilization, its use can be associated with vascular complications. A specific problem related to the device is protrusion of the collagen plug into the artery, causing either acute occlusion or symptomatic stenosis. When this occurs, treatment with balloon angioplasty alone is usually suboptimal, while stenting of the common femoral artery may be undesirable. In this report we describe a novel application of the SiverHawk plaque excision system to treat a highly eccentric stenosis at the site of a previously deployed Angio-Seal. Since the device allows preferential cutting in the direction of the lesion and collagen plug debulking, it may be ideally suited to treat this complication without the need for stenting of the common femoral artery.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Lee
authors.forename: Timinder S
authors.initials: TS
authors.lastname: Biring
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gimelli
mesh_terms: D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D005263:Femoral Artery; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000628:therapy*; D011677:Punctures / Q000009:adverse effects*